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23.2.4 Clinical Pathology Services
Clinical pathology services are not separately reimbursable when furnished to inpatients and outpatients.
A physician can bill for a clinical pathology consultation if the physician is personally involved in the clinical pathology procedure and all of the requirements listed below are met. To be considered for payment, clinical pathology consultation must:
• Be requested by the client's attending physician.
•Relate to a test result that lies outside the expected range in view of the condition of the client.
•Result in a narrative report included in the client's medical record that documents direct physician contact with the client.
•Require the exercises of medical judgment by the physician performing the consult.
•Procedure codes 80500 and 80502 should be used for clinical pathology consultations.
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