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Pathology/Lab Coding Alert

ICD-9 UPDATE:
Get the Most Out of New Family History and Genetic V Codes
Watch coverage rules for medical necessity -- or you could end up with denials Start... Read more
Let Surgical Code Guide Your LEEP Specimen Choice
Codes distinguish biopsy, conization -- make sure you know the difference You receiv... Read more
Want to Show Family History/Genetic Carrier Status? Do This
Don't miss ICD-9's latest V codes for the job Here are new and revised V codes that your ... Read more
Prepare to Use 82270 for Screening FOBT Tests
Here's why you should drop the G codeMedicare released a memo recently that promises the d... Read more
Recognize Immunoassay FOBT -- Here's How
Don't forget the reason for the test Guaiac-based fecal-occult blood tests (FOBT) aren't ... Read more
Reader Question:
Distinguish CRP Codes
Question: What is the difference between the C-reactive protein and high-sensitivity C-rea... Read more
Reader Question:
Learn Method for Fungus Test
Question: Our physician-office lab sometimes tests skin, hair or nail specimens for fungal... Read more
Reader Question:
Clinical Labs Code Symptoms
Question: Noting lethargy and paleness, a physician ordered a CBC that showed normal resul... Read more
Reader Question:
Know Thyroid Diagnosis and Frequency Rules
Question: Why does our lab sometimes get denials for TSH tests ordered for patients on hor... Read more
Reader Question:
Avoid FNA Double-Dipping
Question: If our pathologist examines slides from an FNA that require cytospin concentra... Read more
You Be the Coder:
Work Defines Uvula Code
Question: When our pathologist receives a uvula removed for sleep-apnea treatment, how sho... Read more
Get Ready for PSA and Pap-Related ICD-9 Code Changes
NCD gives medical necessity with new codesExpecting to get paid for prostate specific anti... Read more
Now You Can Code Estrogen Receptor Status
V code tells breast cancer type Physicians can't justify the common breast-cancer drug Ta... Read more
News Brief ~ TC Grandfather Goes Permanent ~ One Way or the Other
Watch decision for independent lab billing  The -grandfather- exception that allows... Read more
Clip-and-Save Chart ~ Make Sure You've Got the Latest 'Reason for the Test'
NCD update uses new ICD-9 codesThrow out those four-digit codes and break out the expanded... Read more
Reader Question ~ Don't Be Fooled by 'Includes Glucose'
Question: When our lab performs a fasting glucose followed by a post-glucose test, can we ... Read more
Reader Question ~ Code per Specimen, per Stain
Question: How should I code the following two scenarios, each of which involves examining ... Read more
Reader Question ~ Distinguish Wet Mounts and KOH Slides
Question: If a physician suspects a vaginal infection when a patient presents for her annu... Read more
Reader Question ~ Know Specimen for Stain Codes
Question: I-m very confused about pathology stains. For instance, is an acid-fast bacillus... Read more
You Be the Coder:
5097 Clarification ~ Not All TC Coverage the Same
Question: You stated in an earlier Q/A [-Scrutinize Technical Component for 85097,- Pathol... Read more
Soon You Can Report AFP-L3 -- Here's How
Liver cancer diagnosis gets boost from new lab code Measuring both total alpha-fetopro... Read more
Losing Pay for Follow-Up Tests? Not With V Codes
Supplementary classification shows medical necessity or patient history If you think V co... Read more
Take a Sneak Peek at New Laboratory Codes for 2007
Don't miss this chance to start your coding planning early Prepare to update your... Read more
Using 1 Code for Breast Cytology Could Leave Money on the Table
Look to the surgical procedure to define the specimen Between 88104 and CPT 88173 , you c... Read more
Reader Questions:
Choose Specific Procedure
Question: When choosing the proper surgical pathology level, what should we do if the fina... Read more
Reader Questions:
Don't Make This PSA Reporting Error
Question: Why doesn't Medicare cover a prostate specific antigen (PSA) test for my patient... Read more
Reader Questions:
See Who Bills 99000
Question: Can an independent lab bill for specimen handling and transport when it provides... Read more
Reader Questions:
Learn Rules for Neoplasm Diagnosis
Question: When diagnosing neoplasms, how should I choose from among the various categories... Read more
Reader Questions:
Use Fecal Lactoferrin for Intestinal Inflammation
Question: The physician orders tests for fecal lactoferrin levels in a patient with ongoin... Read more
You Be the Coder:
Beware Slide Consult Rules
Question: We received a request for a slide consult with slides labeled S06-111A right bro... Read more
Molecular Diagnostics Update:
Capture Pay for Each Nucleic Acid Sequence -- Here's How
Net $$ for cell lysis and primer extension too Confused about how many units of servic... Read more
Quick Quiz:
Test Your 83890-83914 Coding Know-How
Apply CPT 2006 codes like a proYou-ve just read about how to properly use molecular diagno... Read more
Overcome Trio of Lab-Test Denials With Experts' Strategies
Medical necessity and modifiers spell success Word on the street says denials for three l... Read more
Reader Questions:
Scrutinize Technical Component for 85097
Question: Can a hospital bill for the technical component of CPT 85097 when an independen... Read more
Reader Questions:
Distinguish Screening/Diagnostic PSA
Question: A physician ordered a total PSA test for a 66 year-old patient complaining of re... Read more
Reader Questions:
Cell Block Stands Alone
Question: Our lab examines a smear from a BAL specimen, and then prepares a cell block fro... Read more
Reader Questions:
Watch Medical Necessity for C-Reactive Protein
Question: Our lab often gets orders from a local cardiology practice for C-reactive protei... Read more
You Be the Coder:
Work Defines Sentinel Node
Question: What distinguishes a single sentinel lymph node from a single lymph node for c... Read more
Coding All Uterine Specimens the Same? Think Again
Answer 3 questions to pick the right code every time  What's your pathologist... Read more
Clip-and-Save Chart:
Match Pathology Report Keywords to Uterus Codes
Common descriptions and diagnoses lead the way Never again lose money by downcoding a... Read more
News Brief:
Stick With 2 Codes to Report New Waived Test
You must know urinalysis constituents A urine chemistry analyzer newly approved by the FD... Read more
NCCI Tells All So You Can Avoid Payment Pitfalls
Decipher 6 edit-pair explanations Just because National Correct Coding Initiative version... Read more
Reader Questions:
Learn Direct-Billing and Modifier 90 Rules
Question: We are an independent lab that evaluates Pap smears sent to us from physicians- ... Read more
Reader Questions:
Follow Consultation Rules for 80500
Question: A physician ordered a serum alpha-fetoprotein for a hepatitis patient, and recei... Read more
Reader Questions:
Use 91 for Repeat Panel Test
Question: The lab performs a basic metabolic panel, and later in the same day the physicia... Read more
Reader Questions:
Don't Miss Hepatitis Panel Requirements
Question: When a physician orders a hepatitis panel to follow the course of treatment for ... Read more
You Be the Coder:
Code Scope of Work for Bladder Cancer
Question: If we use the Vysis FISH probe kit to aid in monitoring bladder cancer, can we c... Read more
Sacrificing Electronic Crossmatch Pay? Not Anymore
Use new code for matching blood through lab information system The electronic compatibili... Read more
Reduce Volume, Increase Pay With 86960
Capture $12.91 for new transfusion medicine code Pathology codes for transfusion-related ... Read more
Category III:
Code Correctly Now and Get Paid Later
Avoid unlisted-procedure codes for new tests Don't ignore those strange alphanumer... Read more
Put Category III Lab Codes at Your Fingertips
Keep up with emerging-technology codes with this handy toolTired of rummaging through all ... Read more
Reader Questions:
Not All Tzancks Are Created Equal
Question: How should we code a skin smear prepared for a Tzanck test and read by a cytotec... Read more
Reader Questions:
Watch Out for 88342/88360 Discrepancy
Question: Your answer to a recent bone-marrow biopsy coding question describes using CPT 8... Read more
Reader Questions:
Check Frequency for Hepatitis Tests
Question: When physicians order the hepatitis panel to follow a patient's course of ... Read more
Reader Questions:
Follow Rules for Neoplasm Dx
Question: When diagnosing neoplasms, how should I choose from among the various categories... Read more
You Be the Coder:
Check Your Know-How by Coding This Case
Question: A pathologist performs a bone marrow aspiration, examines direct smears, process... Read more
Coding Frozen Sections With Touch Preps? Read This First
New edits could override CPT instructions that will affect your bottom lineAlthough CPT Co... Read more
NCCI Quick Update:
CMS Bundles Different Lab Methods
New edits limit your payment for multiple techniques Labs have many methods to test f... Read more
Follow 5 Steps to Master Modifier 59 Claims
Warning: The OIG says your carrier should crack down on unbundlingWhen you use modifi... Read more
Quick Quiz:
To Unbundle or Not to Unbundle...
Try your hand at these cases to see if you should use modifier 59You've learned the princi... Read more
READER QUESTIONS:
Know When QW Will Get You Paid
Question: I can't find modifier QW in the CPT manual , but I've been told we should use it... Read more
READER QUESTIONS:
Distinguish Purpose for Pap Codes
Question: Is it true that P3000 and HCPCS G0123 are exclusively for Medicare? If so, wha... Read more
READER QUESTIONS:
Reason for Stain Dictates Code
Question: Our pathologist examined the following stains for a liver biopsy: iron, trichrom... Read more
READER QUESTIONS:
Medicare Doesn't Cover Routine Protime Tests
Question: Why don't we get paid when our lab performs PT and PTT tests preoperatively for ... Read more
You Be the Coder:
What's New With Ova and Parasites?
Question: We’ve always reported a trichrome stain on a fecal smear for ova and par... Read more
Take 3 Steps to Perfect Gastrectomy Coding Every Time
Downcoding and bundling can cost you cash When your pathologist examines a stomach re... Read more
Quick Quiz:
Test Your Gastrectomy Coding Savvy
Compare your answers to our experts'You receive a gastrectomy pathology report that includ... Read more
Boost Glycosylated Hemoglobin Payments With New Code
Watch out:  Physician must document reason for frequent A1CDiabetes management may re... Read more
Capture Glycated Protein for Diabetics--Here's How
Hint: Associated conditions warrant test When physicians order glycated protein ... Read more
News Brief:
Lab Groups Win Fight Over 'Medically Unbelievable Edits'
Unit restrictions won't jeopardize rightful pay CMS will not implement the &ldquo... Read more
READER QUESTIONS:
Differentiate Reason for Cytology Review
Question: If a physician submits a cervical biopsy and the pathologist also reviews past P... Read more
READER QUESTIONS:
Use New Code for Drug Assay
Question: When a physician orders drug-level monitoring of sirolimus in the blood for tran... Read more
READER QUESTIONS:
Avoid Modifier 91 Restrictions
Question: An insurance company recommended  we code influenza test A+B as CPT 87804 ... Read more
READER QUESTIONS:
Don't Miss Specific CCP Code
Question: When a physician orders cyclic citrullinated peptide antibody IgG, should we use... Read more
READER QUESTIONS:
Touch Prep After Frozen Is Not 'Initial Site'
Question: Our pathologist examined two colon biopsies identified by location. The service ... Read more
You Be the Coder:
Not All Joint Resections Are Equal
Question: When our pathologist examines bone fragments from joint replacement surgery, s... Read more
CPT 2006:
Think Coding TB Tests Is Old Hat? Not Anymore
Methods define 86480 and 86580 Testing for Mycobacterium tuberculosis (TB) infection ... Read more
Capture Additional TB Tests--Here's How
Code separate stains, cultures and biopsiesPhysicians routinely perform tuberculosis (TB) ... Read more
Stop Payment Denials for Pap Interpretation With CPT Revision
Removing add-on status allows $22CPT 2006 subtracted the "+" from Pap interpretation code ... Read more
Pap-Code Change Means You'll Collect Proper Pay for Review
Updated 88175 clarifies ThinPrep coding Now you can get paid $7 for rescreening your ... Read more
Follow 4 Steps to Choose the Right Pap Code Every Time
Use this clip-and-save chart to simplify your decisions CPT has 14 Pap test codes, so... Read more
READER QUESTIONS:
Use Blood Type Encounter for Rh Test
Question: What would be the better diagnosis code to use for a husband coming in to test f... Read more
READER QUESTIONS:
You Can Ignore Modifier Indicator '9'
Question: What does the "9" in the modifier indicator column of the National Correct Codin... Read more
READER QUESTIONS:
Watch for Entire Panels
Question: When a physician orders a group of lab tests that he calls a specific "panel," b... Read more
READER QUESTIONS:
Learn Why CMS Won't Pay for Thyroid Testing
Question: Our lab frequently gets denials for thyroid function tests. Why does this happen... Read more
You Be the Coder:
Try Your Hand at This Bone Marrow Case
Question: Our pathologist evaluated a bone marrow biopsy and clot section from a patient... Read more
Are You Coding Each Molecular Probe Separately? Not for Arrays
Tip: Reserve 88384-88386 for ‘gene chips’ Simply counting probes won&rsquo... Read more
You'll Get $320 for New Array Codes:
Here's How
Carriers should use corrected RVUs for 88385, 88386 The final fee schedule could lead... Read more
Latest NCCI Allows Frozen Sections With Touch Preps
Warning: Beware of other cytology bundles Finally, you can report frozen sections and ... Read more
Using New Lipoprotein Codes? Watch Out for NCCI Edits
Rules limit new immunology and FOBT codes, too If your lab performs lipoprotein quanti... Read more
Reader Questions:
Know When Secondary Cancer Is Primary Code
Question: If the pathologist examines a malignant lung wedge biopsy for metastasis to the ... Read more
Reader Questions:
Choose From Many Codes for Cervical Thin Prep
Question: Our lab performs Pap exams using the Thin Prep method, and we've had conflicting... Read more
Reader Questions:
When to Use Archive Date of Service
Question: When our pathologists receive a request to examine old specimens, what should we... Read more
Reader Questions:
Watch Out for Slide-Consult Unit of Service
Question: We have three requisitions marked "slide consult" for three slides from another ... Read more
You Be the Coder:
Find Key to Needle-Core Biopsy Codes
Question: Should we code the pathology exam of needle-core biopsy specimens as 88305 or ... Read more
CPT 2006:
New B, NK and CD34 Codes Have Special Rules--Our Experts Weigh In
Reserve 86355-86367 for "total count" immunology If you found last year&rsq... Read more
CPT 2006:
Are You Coding the Method for Lipoprotein (a)?--Not Anymore
Get specific and earn $44.08 for NMR lipoprotein quantitation Clarify your lipid codi... Read more
Now You Can Get $52.70 for 86586:
Here's How
Look for "unlisted antigen" code on the CLFS If you are an independent lab ... Read more
Appealing Bundles for Different Specimens? Here's How
Don't let Medicare's new time frames catch you nappingSometimes Medicare denies your claim... Read more
READER QUESTIONS:
Hematology Lab Tests Include Interpretation
Question: I noticed that Medicare will no longer pay for CPT 85060 for outpatients. How s... Read more
READER QUESTIONS:
You Can't Just Count Markers for Flow-Cytometry Interpretation
Question: When our lab performs flow cytometry to determine an HIV patient's T-cell count,... Read more
READER QUESTIONS:
Code Symptoms for Diagnostic PSA
Question: Our lab received an order for a PSA test for a 55-year-old patient diagnosed wit... Read more
READER QUESTIONS:
Use Specific Codes for Transplant Preparation
Question: When our hematopathologist works with oncologists for stem cell services, we've ... Read more
READER QUESTIONS:
You Won't Find Myeloma Codes in Neoplasm Table
Question: I was unable to find a myeloma diagnosis in the neoplasm table. Am I looking in ... Read more
READER QUESTIONS:
Don't Forget E Codes
Question: When a physician orders a test and describes a condition such as "exposure to ra... Read more
READER QUESTIONS:
Look for Peritoneal Cancer Marker Coverage
Question: When a physician orders a test and describes a condition such as "exposure to ra... Read more
You Be the Coder:
Watch Out for Counter Stains
Question: One of our dermatopathologists uses a Melan-A immunohistochemistry stain with an... Read more
You Can Get Paid for Touch Preps With Frozen Again--Here's How
New codes 88333 and 88334 will help you overcome an NCCI roadblockYou've had to eat the $3... Read more
88161 Bundled With Surgical Pathology A Problem? Not Anymore
New consultation touch-prep codes avoid old NCCI editThanks to a National Correct Coding I... Read more
Clip-and-Save Chart:
Don't Miss These 2006 CPT Pathology and Lab Code Changes
You won't get paid for deleted codes after Jan. 1Starting Jan. 1, you won't use Category I... Read more
Count Specimens to Get Paid For New FOBT Codes
Changes clear up card and DRE confusionIf you're puzzled about when and how to bill for a ... Read more
READER QUESTIONS:
Specimen Counts, Not Cassettes
Question: How should I code the procedure based on the following pathology report: From ri... Read more
READER QUESTIONS:
Edit Hits Tubes and Placenta
Question: At our hospital, we have a fairly common situation when a patient delivers a bab... Read more
READER QUESTIONS:
Watch Out for Calculated LDL
Question: Are there any conditions that warrant performing a lipid panel and separate LDL ... Read more
READER QUESTIONS:
Look for Fat Smear Code
Question: We sometimes perform a Sudan Black IV stain on a stool smear for fat. I've been ... Read more
READER QUESTIONS:
Influenza Test Kit Code Varies
Question: We're considering starting to use an influenza test kit in our physician office ... Read more
You Be the Coder:
What's Bundled in Prostatectomy?
Question: How should we code a radical prostatectomy for adenocarcinoma with benign semina... Read more
Available Years:  2006  2005  2004  2003  2002  2001  2000