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Pathology/Lab Coding Alert
Pathology/Lab Coding Alert
Pathology/Lab Coding Alert - 2005; Volume 6, Number 12
4 Tips Improve Your 88342 Billing
Don't lose $90 for each additional antibodyWhen your lab uses an immunohistochemistry cock...
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Reporting Injection With FNA, Bone Marrow? Not Anymore
Aspirations and needle core include 'stick' codes When a pathologist acquires...
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News Brief:
Use Special Modifier for Disaster-Related Claims
You can use the new code regardless of where you're located Don’t let your ...
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Avoid 'Gross-Only' Pitfalls for Pathologists' Assistants
Billing a physician service? That could be fraudBecause a pathologists' assistant ro...
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Billing Corner:
Don't Ignore Incident-to Rules or You Could Harm Your Bottom Line
Hint: The key is recognition and supervisionIf the term "incident-to" leaves you perp...
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READER QUESTIONS:
Don't Misplace Modifier 59
Question: I know that I can use modifier59 to unbundle codes under the right circumstances...
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READER QUESTIONS:
Consultation Date of Service Differs
Question: What is the correct date of service when our pathologist performs a second-opini...
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READER QUESTIONS:
Look for Anaerobic Culture Exception
Question: How should we code the presumptive identification of anaerobic and aerobic organ...
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READER QUESTIONS:
Code for Comparable Specimen
Question: What code should we use for the pathology exam of the following specimen: "ethmo...
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You Be the Coder:
Code Steps for Hepatitis C?
Question: When our lab identifies the Hepatitis C genotype, should we separately report ...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 11
Focus on Cytopathology Bundling Rules--We'll Show You When to Override Edits
Don't bill separately for 88184-88189 cell reviewIf you're billing separately for a cytolo...
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Get More for Flow Cytometry Technical Services
Medicare fee schedule raises 88184-88185 payment by at least 22 percent After cutting...
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Truncated Diagnosis Could Cost You $49.04
Add the key fifth digit for 287.3 Expecting to get paid for HIV or other lab tests fo...
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Think You Can Code Mohs for Separate Excision and Exam?
Number of physicians should determine your code choiceA pathologist diagnoses a cancerous ...
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READER QUESTIONS:
Not All Shots Are Vaccinations
Question: We are trying to link the purified protein derivative (PPD) tuberculosis test ...
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READER QUESTIONS:
Use Caution With Referral Arrangements
Question: As in independent laboratory, can we charge for blood draws made by our phleboto...
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READER QUESTIONS:
Coding Repeat Blood Counts? Read This First
Question: Sometimes, the transplant/stem cell physicians at our hospital send us two sampl...
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READER QUESTIONS:
Thyroid Tests Call for Medical Necessity
Question: We frequently receive denials for thyroid function tests, especially TSH. Why do...
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READER QUESTIONS:
Save Modifier 90 for Independent Labs
Question: What are the restrictions on using modifier 90 for billing referred lab tests?Te...
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You Be the Coder:
Watch Out for Sequential Procedures
Question: Our pathologist extracted a fine-needle aspiration specimen from a breast lesi...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 10
Zero In on Breast Specimens With Your New Best Coding Tool
Don't miss the 88305/88307 distinction Some breast coding is easy - but there'...
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Test Your 88305/88307 Breast Coding Savvy
Don't code undocumented marginsTry your hand at coding breast-lesion excisions using the p...
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Watch for 3 Complications When Coding Special Stains
Don't get tripped up on stain name Each time you choose between 88312 and 88313, ...
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Say Goodbye to 88313 With Fecal Ova and Parasites
Check out CPT 2006 microbiology stain codeStill confused about how to report a trichrome s...
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Biopsy or Excision? Difference Explained in Coding Terms
Know the surgeons' language to decode breast tissue Here's a surprise: Understanding surg...
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READER QUESTIONS:
Unbundled With NCCI Modifier Indicators
Question: In the National Correct Coding Initiative (NCCI) edits, what do the modifier i...
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READER QUESTIONS:
For Unsatisfactory Smear, Use 795.08
Question: Which diagnosis should I use for a Pap smear ordered due to a prior unsatisfacto...
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READER QUESTIONS:
Learn to Code Flow Cytometry's Multiple Markers
Question: Our pathologist performs a flow cytometry cancer study looking at CD45, CD34 and...
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READER QUESTIONS:
Cell Storage Stands Alone
Question: Our Medicare payer tells us that we cannot bill for 88184 with G0265 when our l...
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You Be the Coder:
Avoid Microbiology Trichrome Dilemma
Question: When our pathologist examines a trichrome stain on a fecal smear for ova and p...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 9
Unbundling More Extensive Procedures NCCI Says Think Again
You can't override '0' modifier indicator Watch out for new edit pairs yo...
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Sneak a Peek at New Laboratory Codes for 2006
Prepare for lipoprotein and molecular diagnostics code changes ...
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Prepare to Change How Your Lab Reports TB Assay
New blood-test code 8648x changes how you manage TB testing A new test for tuberculos...
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Forget These Screening Codes?
Forget payment from CMSV codes play a vital role in Medicare's screening services - and fa...
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Stop Losing Cash Over V Code Myths
V codes can document the need for a test Don't shun V codes because you believe s...
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READER QUESTIONS:
Margins Define Breast Specimen
Question: When our pathologist receives a breast lesion, the surgeon sometimes identifies ...
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READER QUESTIONS:
Watch Out for Identical-Claim Edit
Question: We're a reference lab, and we've recently gotten a few Medicare denials with a m...
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READER QUESTIONS:
Use a Modifier for a Repeat Test
Question: A physician ordered two glucose tests in one day based on a patient's diagnosis ...
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READER QUESTIONS:
More Specific Code Reports Cross Match
Question: When our pathologist consults on a blood cross match, should we report a clinica...
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READER QUESTIONS:
Only Special Stains Are Separate
Question: Please help with coding for the following scenario: three slides from pelvic was...
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You Be the Coder:
Know Your Epididymis Codes
Question: What are the correct diagnosis and procedure codes for the following specimen: R...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 8
Using 20220 When Pathologist Takes Bone-Marrow Biopsy? Think Again
Here's how to avoid this coding red flag Yes, you have to use a CPT surgery code when your...
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3 Modifiers Tell the Tale of ABN Status
Get Medicare to tell patients they must pay When you tell a patient he'll have to pay for...
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Noncovered Lab Tests Don't Have to Mean Lost Revenue
Use ABNs to encourage patient payment Just because an ordered lab test isn't covered does...
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'History of' and Genetic V Codes Show Medical Necessity
Use ICD-9 changes to confirm reason for lab tests If you're looking for a better way to s...
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Reader Questions:
Differentiate Screening and Diagnostic Codes
Question: When coding for a lab test, does it matter if the physician ordered the test for...
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Reader Questions:
V Codes Clarify Genetic Susceptibility
Question: Tennessee Subscriber Answer: Don't report the condition as if...
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Reader Questions:
Each Specimen Requires 88331
Question: How should I code a pathology report that lists frozen section exam from a breas...
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Reader Questions:
Diagnose Insulin Use in Diabetes
Question: A physician orders repeated blood glucose tests for a patient diagnosed with typ...
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You Be the Coder:
Must Pathology Consultation Stand Alone?
Question: When our pathologist is called into surgery for immediate diagnosis of a breast ...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 7
Tell the Whole Story With Genetic-Testing Code Modifiers
2-character modifier just might get you paid You may not be using them yet, but CPT...
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Clip-and-Save Chart:
Cross-Reference Your Lab Tests to CPT 2005 Genetic-Test Modifiers
Post this chart in your lab for easy reference to the new genetic-testing code modifiers...
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Don't Miss Payment for New Electrophoresis Codes
Look for pro-fee denials with non-serum sources You've always billed for your pathologis...
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Improve 'Second Chance' for Claims Denials
Prepare now for quicker appeals turnaround Now's the time to streamline your lab...
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Reader Questions:
Bone Marrow Depends on Site
Question: The pathologist examined a bone marrow biopsy from the left iliac crest and a bo...
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Reader Questions:
Check NCD for Denial Clues
Question: Our lab frequently faces denials on thyroid function test claims. Why does this ...
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Reader Questions:
Know Local Coverage Rules
Question: I've heard that an LCD can help us avoid denials on laboratory diagnostic tests....
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You Be the Coder:
Does Records Review Make Consultation?
Question: Our pathologists always review patient records when they examine a bone-marrow o...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 6
Avoid These 3 Pitfalls to Improve Your ICD-9 Skills
Make sure to code the most specific diagnosis You have to know when you should ...
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Quick Quiz:
Test Your Diagnosis Coding Savvy
Use these clinical examples to sharpen your skills You're faced with an outpatient patholo...
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Touch Preps Hit With Tough NCCI Edit
You can't override new cytopathology or thyroid bundles Watch out for two new National Co...
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5 Tips for Flawless Neoplasm Diagnosis Coding
Know the ICD-9 table and terminology to get the code right When the pathologist...
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Decipher Malignant, In Situ and Uncertain
Use this primer to zero in on neoplasm type If you wonder what "behavior&q...
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Reader Questions:
Concentration Changes Sputum Code
Question: Our pathologist sometimes examines a sputum cytology cytospin and cell block. We...
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Reader Questions:
Use Current Codes and Date for Archives
Question: A physician recently sent a breast tissue specimen to our pathologist for a HER-...
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Reader Questions:
Choose 1 Test for Diabetes Screening
Question: Physicians often order a fasting glucose (CPT 82947 ), followed two hours later ...
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You Be the Coder:
Use Listed Specimen for Surgical Pathology
Question: Our pathologist examined a colon resection for tumor and diagnosed metastatic ov...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 5
Choose the Right Flow Cytometry Codes in 6 Easy Steps - Here's How
You can't count on 'per marker' coding for flow cytometry anymore After eliminating 8818...
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Quick Quiz:
Get a Grip on Flow Cytometry Changes for 2005
3 scenarios put your cancer immunophenotyping coding knowledge to the test Still tryi...
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Use 86586 for Unspecified Immunology Counts
Don't report flow cytometry for clinical lab tests You'll need to learn a new way to use "...
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Make Sure You Get Paid for Pre-Diabetes Screening
Modifier -TS ups the frequency ante You've been performing glucose tests to screen at-ris...
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Medicare Screens All Patients With Diabetes Risk
But pre-diabetes means more frequent testing Medicare's annual screening coverage a...
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Reader Questions:
Document Collection Date for Billing
Question: For blood tests, should our lab report the date of service as the day of the blo...
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Reader Questions:
Diagnosis Is Key for Lipid Tests
Question: Our lab performs regular lipid testing for patients with disorders such as hyper...
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Reader Questions:
Don't Unbundle Cytology Smears
Question: When the cytotechnologist prepares cerebrospinal fluid for evaluation, we someti...
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You Be the Coder:
Add Up Unique Lab Panel Codes
Question: When a physician orders an evocative/ suppression panel for hormones, the grou...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 4
Use These 4 Tips for Reporting New and Revised IHC Codes
Lab method and results determine your code selection CPT 2005 changes the way you report t...
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Be Sure You Reserve 88342 for Qualitative IHC
Counting cells earns semiquantitative payDon't be confused by reports that IHC grading sys...
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Here's How to Get Paid for Bone Marrow Biopsy and Aspiration
Maneuver coding restrictions with modifier and G code If you're reporting a bone...
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Put Another V Code on Your Pap Screening List
CMS expands payable diagnosesYou can look forward to getting paid for screening Pap smears...
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READER QUESTIONS:
Know -TC Grandfather Exception Rules
Question: Has the "grandfather exception" expired, which allows independent labs to bill M...
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READER QUESTIONS:
Use E/M Cautiously for Test Encounters
Question: We operate a physician-office lab that monitors coumadin levels in patients on a...
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READER QUESTIONS:
ICD-9 Help Abounds
Question: Because physicians can order lab tests with a narrative diagnosis, we sometimes ...
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READER QUESTIONS:
Don't Confuse Screening and Diagnostic FOBT
Question: Which codes does Medicare cover for the screening fecal-occult blood test?Colora...
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You Be the Coder:
Watch Out for Modifier Indicator
Question: A physician sent two specimens from a single patient to our lab: a Pap smear, an...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 3
Update Your ISH/FISH Coding - Here's How
CPT Codes 2005 expands 88365-88368 CPT 2005 erased the line in the sand - you should ...
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Test Your ISH Coding Skills
Try coding the following scenarios, then see what our expert saysExample 1: A pathologist ...
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Classify ISH Test as an Adjunct Service
Surgical/cytology service versus clinical cytogenetics distinguishes codes With two s...
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NCCI 11.0 Limits Use of New CPT 2005 Codes
Don't report flow cytometry with immunology, cytopathology If you want to code 20...
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Separate Infusion/Injection Billing Won't Do
Beware of NCCI 'G' code bundles Medicare created new HCPCS Level II codes for...
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READER QUESTIONS:
Watch for New PAPP-A Code
Question: What is the correct way to bill for a pregnancy-associated plasma protein-A (PAP...
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READER QUESTIONS:
Drop G0001 for Medicare Venipuncture
Question: Can the lab bill for blood collection? Which code should we use?Ohio SubscriberA...
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You Be the Coder:
Specify Diagnosis With External-Causes Codes
Question: The lab received an order for an HIV test as part of a workers' compensati...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 2
Scrutinize Diagnoses Before You Bill Screening Tests
"V" codes show medical necessity for diabetes, heart disease Now your lab can get paid fo...
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Get Screening Test Frequency Right - or Get an ABN
Don't forget to add -GAYou can't exceed Medicare's frequency limitations for diabetes or c...
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2005 Medicare Payments - How Will Your Lab Fare?
You'll see little growth to pathologists' fees The big winners on Medicare's 2005 Physic...
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Follow These 3 Steps to Report a Non-Diagnostic Specimen Exam
Document work, specimen description to assign proper 88300-88309 Just because your pathol...
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Quick Quiz:
Test Your "Inadequate Specimen" Coding Savvy
Use these clinical examples to sharpen your skillsYou're faced with a pathology report tha...
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Reader Questions:
Specimen Is Frozen Section Unit of Service
Question: How should we use the frozen section codes for the following situation: The path...
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Reader Questions:
Same Organism Tests Are Mutually Exclusive
Question: If the lab performs a hepatitis C qualitative PCR and an HCV RNA quantification ...
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Reader Questions:
Newly-Stained Slides Warrant Code
Question: When our pathologist receives a tissue block with a request for consultation, he...
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You Be the Coder:
Choose One Procedure for Cytopathology Specimen
Question: Is it ever appropriate to separately bill two cytopathology methodologies for th...
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Pathology/Lab Coding Alert - 2005; Volume 6, Number 1
CPT 2005:
Here's How to Use the New B, NK and Stem Cell Codes
They're not for hematolymphoid phenotyping CPT 2005 adds three new immunology codes for c...
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Coding Basics:
Choose the Right Modifier for Repeat or Bundled Tests
-59 or -91 tells the whole story If your lab performs the same test twice or performs ...
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Stay on OIG's Good Side - Use Modifier -59 Wisely
Don't report similar tests for one specimenWhen you bypass National Correct Coding Initiat...
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Keep Up With the 2005 CPT Code Changes
Here it is, all in one place - a complete list of about 40 code additions, deletions, revi...
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Reader Questions:
Identify Drug-Resistant Infections
Question: Our lab is seeing a rise in cultures that identify penicillin-resistant staph in...
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Reader Questions:
Report Ordering and Final Diagnosis for Paps
Question: Our lab performs high-risk HPV DNA testing for every Pap smear that has a result...
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You Be the Coder:
Electrophoresis - Here Are the 2005 Changes
Question: I am billing the professional side only for the following tests: serum protein e...
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