There are differing opinions in my office about how to bill for flow cytometry testing. To elucidate the difference, I need to give an example:

A patient has blood drawn in the morning. The doctor orders two different flow panels to be tested. Later that day, the doctor decides to draw blood again, and order a third flow panel. The pathologist issues 3 separate reports: 1 for each panel.

There are three interpretations of how to deal with the "1st marker" code (88184):

  1. Only one instance of 88184 is allowed per patient per day: In this example, 88184 would be billed once.
  2. One instance of 88184 is allowed per draw: In this example, 88184 would be billed twice.
  3. One instance of 88184 is allowed per issued report: In this example, 88184 would be billed thrice.

Which interpretation is correct? More importantly, can you provide a reliable reference supporting your answer?

  • What are your thoughts on it? Is this something you have research at all prior?
    – L.B.
    Mar 20 '19 at 18:49
  • Hi @matt2103, I have doubts that you will find someone familiar with such an obscure coding and billing issue here, as our expert base is rather small, and there are very few subspecialties that routinely do/bill flow cytometry.
    – DoctorWhom
    Mar 21 '19 at 6:55
  • @DoctorWhom Thanks for the comment! I knew this was a shot in the dark--I'm actually impressed that I even got a response from someone who understands how obscure flow cytometry billing is. I figured I'd try before shelling out to join a professional community.
    – matt2103
    Mar 22 '19 at 19:26
  • 1
    @L.B. Yes, I've done my homework, and there is precedent to suggest that answer number 1 is correct. Most procedures, lab tests or otherwise, are considered a single unit when they are performed in a single day. The difficulty comes in convincing my superiors (who would obviously prefer to bill more), and that requires a specific reference. The CPT codebook we refer to here doesn't have any specific guidance for flow cytometry billing.
    – matt2103
    Mar 22 '19 at 19:32

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