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Posted By Cathy on 05-30-2019, 09:39:29 in Ob-Gyn
Melanie...We performed an EMB on 5/1 and the path report came back with Endometrium, biopsy-single, minuscule fragment of endometrium, insufficient for evaluation of endometrial pathology; fragments of unremarkable endocervical mucosa and mucus.
We repeated the EMB on 5/23/19 with successful sampling/pathology. Should we bill for the first one with modifier 52 or bill an office visit instead? If we can bill for both, what diagnosis code represents insufficient sampling? The only codes I can find are for inadequate smears.

Everytime I attempt a search in this forum I don't get results, I get a message that it has timed out. Is there a secret to searching the archives? Thank you, Cathy Satkus, CPC Harvard Family Physicians
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Posted By Melanie Witt on 06-04-2019, 16:15:33
You do not add a modifier -52 to the first EMB because you actually performed the procedure - the fact that the sample was inadequate is not linked to completion of the procedure. The payer will decide if you can bill for both, but I would use the modifier for a repeat procedure on the second one (-76). As to a diagnosis, I can find nothing that applies so simply list the reason for the EMB initially and then have documentation ready to go in explanation of the circumstance.
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