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Pathology/Lab Coding Alert
Pathology/Lab Coding Alert
Pathology/Lab Coding Alert - 2010; Volume 11, Number 12
CPT 2011:
88172, 88177 Changes Could Smash MUE Roadblock
Capture each 'evaluation episode' for FNA adequacy checkPer "pass" or per lesion -- h...
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CPT 2011:
Clip-&-Save: Welcome 12 New and Revised Pathology Codes
Handy table summarizes microbiology, surgical pathology, and cytology changes.If you've be...
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CPT 2011:
CMS Slashes Reimbursement, Requires Clinical Lab Requisition Signatures
Conversion factor double dips to Jan. 1 low.Medicare's conversion factor (CF), the multipl...
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Reader Question:
88304 or 88305 for Ligament?
Question: My pathologist states that the work for a ligament specimen exam is equivalent t...
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Reader Question:
38221 + E/M " Here's How
Question: Sometimes our hematologist sees a patient for the first time; performs an E/M co...
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Reader Question:
88342 Units Can Vary
Question: I'm confused about whether I can code 88342 per block of per specimen -- wh...
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You Be the Coder:
Do 82550 and 82552 Stand Alone?
Question: Our lab performs creatine kinase and isoenzymes to aid in diagnosis of acute myo...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 11
CPT 2011; 84112 is Your Ticket to the PROM
Pick up on phospholipid code changes, too.If you've been wondering how to report the PAMG-...
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CPT 2011:
Clip-and-Save: Welcome 9 New Specific Codes for Clinical Lab
Handy table looks ahead to next year's pricing, too.From gastric acid monitoring to a tube...
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CPT 2011:
88332, 88334: Make Sure You Capture Every Intraop Consult Preparation
"List separately" instruction clarifies coding for additional slidesIf you get bogged down...
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Capture All the Pay You Deserve for Frozens and Touch Preps Together
Frozens are 'first' -- touch preps are 'additional.'You've just read how CPT 2011 hel...
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Reader Question:
Let Payer Guide Screening Pap Code Choice
Question: Our lab performs a liquid-based screening Pap, and finding abnormality, refers t...
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Reader Question:
82952 Captures Additional Glucose
Question: We do the same lab test for 82947, 82950, 82951, and 82952 -- is the number of g...
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Reader Question:
88314 Parallels Specimen Number
Question: Our pathologist receives 11 to 14 muscle and nerve biopsy specimens and performs...
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You Be the Coder:
88321: You Won't Always Choose the Same Units
Question: We received slides from an outside institution that are from three separate case...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 10
CCI 16.3:
Heed New Edits to Avoid Lipoprotein Double Dipping
And look for hemoglobin modifier change -- again.Make sure you keep your lab in compl...
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Reimbursement:
Find the Fee Schedule for Your ER/PR Pay
Professional and technical billing impact your bottom lineYou have five code choices for e...
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Microbiology:
Unlock Culture and Shiga Toxin Antigen Test Pay With 4 Expert Tips
Don't lose $$ over negative results.Stool testing for patients with diarrhea might involve...
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Diagnosis Coding:
CMS to Freeze ICD-9 Code Set Next Year
2011 will be the last time for complete update.CMS has followed through on its proposal to...
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Reader questions:
Learn HIV Risk Factors
Question: I understand that Medicare has an expanded HIV screening policy for patients in ...
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Reader questions:
Choose Susceptibility by Method
Question: What code should we use for a culture "screening" test for Group B Streptococcus...
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Reader questions:
Limit Consult to Case
Question: How should I code a consult report on two slides from the same date: slide A is ...
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Reader questions:
Focus on PSA Results
Question: A physician orders a diagnostic PSA test for a patient diagnosed with BPH based ...
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Reader questions:
Capture Stains and Conditions
Question: Our pathologist examined a liver biopsy and used a trichrome stain for fibrosis ...
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You Be the Coder:
Don’t Let Screening Fool You
Question: When the surgeon performs a screening colonoscopy, finds a polyp in the right co...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 9
CPT Analysis:
4 Steps Ensure That You Clear Every ER/PR Coding Hurdle
Know CPT's assay/stain distinction to pick the right code.The adage to "always report the ...
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IHS Stain Unit Change Could Benefit Your Bottom Line
Count specimens -- or maybe blocks to get all the pay you deserveFor years the immuno...
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Medicare Compliance:
Maximize Lipid Screening Pay -- Here's How
Acknowledge frequency and diagnosis restrictions.Medicare -- and other payers --...
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Audit Alert:
Learn RAC Fast Facts Before Your Audit Comes
Establish contact person to track audit compliance.Maybe your lab hasn't faced an audit fr...
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Reader questions:
Distinguish Specimen, Site for Intraoperative Squash Preps
Question: Our pathologist examines specimens labeled "right sentinel node # 1" and "right ...
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Reader questions:
Beware PhD Cytogenetics Service
Question: How should we charge for PhD interpretation of cytogenetic tests? Are there any ...
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Reader questions:
Let Pathology Report Determine Behavior
Question: I'm confused as to whether tubulovillous adenoma colon polyps are benign or unce...
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Reader questions:
Deconstruct Panels to Find Most Comprehensive
Question: When a physician orders a renal function panel and hepatic function panel, can I...
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Reader questions:
Limit Warfarin Responsiveness Test to Trial
Question: Our lab is performing a genetic test for warfarin responsiveness for certain pat...
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You Be the Coder:
Gestational Age is Key
Question: When the pathologist examines a placenta with the request to look for signs of a...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 8
CPT 2011 Preview:
Get Ready for Drug Test Changes -- Again
Don't let proposed CPT and 'G' codes confuse you.With two new codes proposed for urine dru...
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CPT 2011:
Welcome 16 New Specific Codes for Up-and-Coming Lab Tests
Bonus clip-and-save chart gives you a handy new code preview.From three new influenza test...
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You Might Get More Pay for PCT, Thromboxane, ATP Tests
Stat sepsis diagnosis uses more of your lab's resourcesPlenty of laboratorians agree ...
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Reader Questions:
Judge 88172 by Payer
Question: During a breast fine needle aspiration (FNA), the surgeon submitted an aspirate ...
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Reader Questions:
Look to Benign Neoplasm for Clark's Nevus Diagnosis
Question: The pathology report for a skin lesion states "Clark's nevus" as the diagnosis. ...
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Reader Questions:
Draw Dx Line at PIN III
Question: The pathology report for a prostate biopsy gives this diagnosis: "high-grade pro...
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Reader Questions:
Establish Specific Dx for Thyroid Function Tests
Question: If a physician orders total T4 and TSH tests for a patient with hypothyroidism f...
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Reader Questions:
Medical Necessity Snags Urine Culture Pay
Question: A physician ordered a urinalysis with a reflex to urine culture for findings o...
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You Be the Coder:
Capture Every Step for Sentinel Lymph Node Pay
Question: Our pathologist received a sentinel lymph node biopsy specimen for a breast canc...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 7
CCI 16.2:
Shun Extra Tissue Prep Charge for Micro and Flow
New bundles confirm 88387-88388 restrictions.CPT 2010 opened the door to charges for steri...
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Reserve +88388 for Use With Intraoperative Consults
CCI 16.2 bundles 88387 with surgical consult codes.In case you're having trouble choosing ...
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CCI 16.2:
Avoid HCPCS Level II Edit Pairs or Miss Drug Screen Pay
Distinguish telehealth from lab consults, too.Effective July 1, you have plenty of new edi...
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CCI Slashes Ability to Separate CBC Edits
Modifier indicator change from '1' to '0' ties labs' hands.Correct Coding Initiative (CCI)...
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Compliance:
Reference 3 'G' Codes for Early HIV Screening
Don't miss out on rapid test pay for high-risk beneficiaries. Your lab can now sho...
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Reader Questions:
Jump Start Phlebotomy Charges - Here's How
Question: When our lab performs the blood draw as well as the lab test, such as CBC, can w...
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Reader Questions:
Many Options Tell Multiple-Specimen Story
Question: I'm new to pathology coding, and I see codes such as 88305 with modifier 76. I'v...
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Reader Questions:
Lipoma Trumps Non-Specific Dx
Question: Our pathologist received a specimen labeled "right breast mass," and the patholo...
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Reader Questions:
Bill Immunostains Per Antibody
Question: Should we bill a prostate triple stain as 88342 or 88342 x 3?Florida SubscriberA...
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You Be the Coder:
CCI Slashes Ability to Separate CBC Edits
Question: We're using 86356 to bill for CD45RA and CD45RO counts -- should we bill th...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 6
ICD-9 2011 Update:
Focus Transfusion Reaction Dx With Host of New Codes
Revisions spotlight iron metabolism disorders.If you ever bill transfusion medicine codes ...
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ICD-9 2011:
Tackle Acute/Delayed Distinction for 999.6x-999.8x
Use fifth digit to distinguish hemolysis, other transfusion reactions.Stating "ABO (or Rh)...
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HPV Testing:
Collect HPV Pay with Proper Screening vs. Reflex Diagnoses
Align 'medical necessity' with ICD-9 instruction.Ordering a human papillomavirus (HPV) scr...
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Reader Questions:
Identify Most Specific Cancer
Question: The pathologist examined a skin lesion removed from the patient's nose identifie...
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Reader Questions:
Count Frozens Per Block
Question: How should I code a lung lobectomy specimen, including two frozens -- one o...
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Reader Questions:
Code Tests that Pathologists Order
Question: Does the referring physician need to request the PAS/Alcian blue stain before th...
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Reader Questions:
Don't Miss Screening Culture Code
Question: A physician performed a rapid strep test in the office and sent out a throat s...
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You Be the Coder:
Distinguish 1-Sided Hip Joint Resection
Question: Our pathologist received a container labeled "bone and tissue, left hip." It con...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 5
CPT 2010:
Don't Miss Out on the Molecular Diagnostics Prep Pay You Deserve
Let our experts' scenarios show the way for macrodissection billing. Wondering when your ...
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Medicare Compliance:
Distinguish Voluntary ABN With This Modifier
All new GX and revised GA clarify liability statement. Ever since CMS rolled the Notice of...
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Bust These 5 ICD-10 Myths With Expert Answers
Start now to get your lab ready for the new diagnosis code set. If the ICD-10 implementat...
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Reader Questions:
Use Basic Antibody for IgG Class
Question: Our lab performs a Chlamydia antibody panel that tests for IgG an IgM for three...
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Reader Questions:
Watch for KX Gender Notification
Question: I've heard that Medicare has a new way to override genderspecific edits, when a...
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Reader Questions:
Limit 85060 to Medicare Inpatients
Question: Our pathologist reviewed a peripheral blood smear as a reflex test from an abno...
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Reader Questions:
Let Pathologist Judge Unlisted Anal Specimen
Question: Our pathologist received two distinctly identified anal condylomata and an anal...
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Reader Questions:
Zero In On Separate 'Total' and 'Free'
Question: Our lab performs a quantitative and qualitative analysis of free and total carb...
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Reader Questions:
Limit Consults to Referred Material
Question: The pathologist performed a colon biopsy exam. Three weeks later, the oncologis...
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You Be the Coder:
Solve PhD Interpretation Dilemma
Question: We have a PhD performing molecular diagnostics and molecular array testing in o...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 4
CPT 2010:
Garner Molecular Studies Preparation Pay -- Here's How
6 tips show you the do's and don'ts of using 88387 and +88388. When your pathologist pe...
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Venue Solidifies Your 88387+88388 Code Choice
Capture this add-on for intraoperative consultations. Chose the wrong code and you co...
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CCI 16.1:
Skip Coding Analyte and Method Together
But you can break bundles when testing separate constituents. You'll need to be on your...
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The OIG is Watching Your Modifier 59 Claims -- Are You?
Make sure you meet distinct service criteria before you unbundle. With the Office of In...
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Reader Question:
Hepatitis Doesn't Guarantee Panel Pay
Question: A physician ordered a hepatitis panel with diagnosis code 070.51, but Medicare...
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Reader Question:
Be Careful of 'Routine' Special Stains
Question: When we bill for electron microscopy, can we separately code the toluidine blu...
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Reader Question:
Payer Leads the Way for Proper Pap Coding
Question: How should we code a case when we process a routine screening Pap smear but due...
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You Be the Coder:
Learn Frozen Section Counting Rules
Question: Our pathologist consulted during surgery for a lesion excision case involving f...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 3
CPT 2010:
Welcome 86825-82826 -- Serology Isn't the Only HLA Crossmatch
Distinguish typing/crossmatch methods to help you pick the right code. After years of bei...
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Keep HLA Codes Straight With This Transplant Primer
Understand testing process to see how codes work together. If you don't know "typing" fro...
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Bone Up on Bone Bundles to Bring Home Medicare Pay
Choose 38220-59 or G0364 depending on surgical conditions. Whether you'll see Medicare pa...
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Clip-n-Save:
Use This Handy Chart to Keep Medicare's Bone Rules at a Glance
Don't double dip on extraction and evaluation pay. Bone sampling and interpretation offer...
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READER QUESTIONS:
Match Diagnosis to Findings
Question: An ob-gyn submitted 3 cm sections of right and left fallopian tubes with a surg...
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READER QUESTIONS:
Abandon POS/DOS Direction
Question: Could you please explain Medicare's new rules for place of service and date of ...
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READER QUESTIONS:
Gain Bronchial Pay With This Tip
Question: From a Medicare patient, we received a bronchial brushing labeled "right lower ...
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READER QUESTIONS:
'Without Mention' Grants Diagnosis Leeway
Question: If pathologic findings from a bone marrow biopsy and immunohistochemistry indic...
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You Be the Coder:
Resolve FNA With Cell Block Question
Question: I've heard that we can't bill any additional preparations with an FNA specimen....
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 2
3 Tips Get You Ready for G0430 and G0431
Learn drug screen code changes for now; expect more change for April 1. You have two new ...
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Not Unbundling 86780 Could Get You in Hot Water Get You in Hot Water
Find a solution to surprising CPT OB panel instruction. You wouldn't think that one simpl...
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Distinguish 'Unspecified' Vs.'Uncertain' Neoplasms -- Here's How
Don't let 238/239 confusion leave medical necessity to chance. You may feel "...
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Reader Question:
Heads Up on DOS Policy Change
Question: Did CMS's date of service rules go into effect on Jan. 4 as planned? Florida Su...
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Reader Question:
Don't Expect Pay for Routine HPV With Pap
Question: Our lab has a client physician who orders a human papillomavirus test with ever...
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Reader Question:
Reserve QW for Waived Labs
Question: The lab that I work for has a CLIA Certificate of Compliance. Do I need to use ...
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Reader Question:
Strengthen Your Thyroid Coding Know-How
Question: A physician ordered a thyrotropin releasing hormone stimulation panel, anti-thy...
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You be the coder:
Can You 'Add Up' Large Arrays?
Question: Our lab performs a molecular diagnostics "array" test that involves more than 1...
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Pathology/Lab Coding Alert - 2010; Volume 11, Number 1
CCI 16.0:
Get With the Bundling Program Before You Use New Culture Codes
Look for transcutaneous hemoglobin limitations, too. Think you’re ready to use a...
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CCI 16.0:
Add-On Doesn't Mean Add-Up 88387-+88388
Choose 1 macrodissection code based on primary procedure. Don’t let the + sign c...
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Surprise Instruction:
Report Special Stains Per Block
Should you throw the ‘specimen’ convention out the window? For surgical pa...
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Back to Basics:
Let this CCI Primer Make You an Edit-File Pro
Missing modifier could mean missing legitimate lab test pay. What do you have to lose ...
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CCI edits, mutually exclusive, column 1/column 2, modifier indicator
Question: When our lab performs rapid testing for influenza A and B, should we use modif...
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Reader Question:
Solve Pinworm Edit Mystery
Question: I was told that we can’t bill a pinworm exam with a prostate saturation ...
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Reader Question:
Get Ready for ABN Modifier GX
Question: I noticed in an MLN Matters article that we’re getting new advance benef...
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Reader Question:
Breathe a Sigh of Relief for Conversion Factor
Question: I’m very confused about what Medicare will pay for pathology physician s...
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You Be the Coder:
Capture Adrenal Gland Pay
Question: The pathology report documents a “radical nephrectomy” and provide...
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