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Pathology/Lab Coding Alert

Hematopathology:
3 Tips Substantiate Bone Marrow Case Study Coding
Grab separate biopsy, aspirate, and clot pay. Bone marrow cases can have lots of compl... Read more
ICD-10:
Expect Direct 289.9 to D75.9 Diagnosis Crosswalk
But coagulation defects exit 'other specified' category. You can expect some s... Read more
85060:
Limit Peripheral Smear to Medicare Inpatients
Other payers may cover the service. Pathologists typically receive a peripheral blood smea... Read more
Place of Service:
Stay the Course on POS Reporting -- For Now
Pathology/lab instruction to follow. First it was April 1, then Oct. 1, 2012 -- now ... Read more
Revalidation:
Clear Up Your Medicare Re-Enrollment Questions With This Update
Missed deadline means 'deactivation' instead of 'revocation.' When you receive your lab's... Read more
Reader Question:
Don't Miss Additional Cytology Services
Question: Our pathologist received a bronchial lavage specimen from a Medicare patient an... Read more
Reader Question:
Scrutinize TC Denials Following 'Grandfather' Expiration
Question: Since the TC Grandfather Provision ended July 1, 2012, we're receiving approxim... Read more
Reader Question:
Don't Create Electrolyte 'Panel'
Question: A physician orders blood electrolytes potassium, sodium, calcium, chloride, mag... Read more
You Be the Coder:
Solve 'Trigone of Bladder' Mystery
Question: What is the correct procedure code for our pathologist's examination of a ... Read more
CLFS Pricing Proposal:
Don't Expect Pay for MAAA Algorithm
Just add up the lab tests, CMS says.Despite consistent stakeholder recommendations to pric... Read more
ICD-10:
758.0 Down Syndrome -- Just One Code is Not Enough for ICD-10
Specific and unspecified codes will give you 4 choices.Once CMS implements ICD-10 beginnin... Read more
Clip-and-Save Chart:
Follow Medicare Pricing to See How You'll Fare in 2013
Use this handy table to get a jump on new CPT 2013 Codes and their recommended Medicare ... Read more
Molecular Pathology Payment:
Wait for Gapfill to Learn Your Molecular Pathology Pay
CMS indicates CLFS, perhaps some MPFS pay.The Clinical Lab Fee Schedule (CLFS) is for mole... Read more
Compliance:
88305: Is 4 the New Prostate Biopsy Maximum for Medicare?
Palmetto GBA policy sets the tone. "I'm concerned that payers may interpret t... Read more
Reader Question:
G0431 or G0434 Could Describe Immunoassay
Question: Our lab performs an immunoassay drug screen for six drug classes for a Medicare ... Read more
Reader Question:
Ink in the New ICD-10 Implementation Deadline
Question: Will we still need to convert to ICD-10 Codes , or has the use of ICD-9 been ext... Read more
Reader Question:
Malignant Behavior Leads Struma Ovarii Choice
Question: The pathology report states, "right ovary with struma ovarii showing multifocal ... Read more
Reader Question:
Collect from Patient After Secondary Insurance
Question: Often, when we perform lab tests, the patient has secondary insurance, some of w... Read more
You Be the Coder:
88108 Gets Bladder Washing Green Light
Question: Our cytopathology lab received a bladder washing specimen with the clinical di... Read more
Anatomic Pathology:
1-2-3 Examples Elucidate Ovary Coding
Bundles aren't always 'hard and fast.' With six "ovary" listings... Read more
Molecular Pathology:
Greet 13 New Tier I Codes in CPT® 2013
But payment remains a mystery.The biggest news at the annual CMS clinical laboratory Fee S... Read more
News You Can Use:
Prepare for 2013 Lab and Pathology Medicare Pay Cuts
Learn what's possible, and watch for final rule and Congressional changes.There may be som... Read more
CPT® Ovary Options
Although the code numbers overlap, you need to be familiar with six distinct code listings... Read more
ICD-10:
Enter 'Right,' 'Left' for Ovarian Cancer Specificity
You'll keep a general code, too. ICD-9 keeps it simple for primary ovarian neoplas... Read more
Reader Question:
Pathololgic Fracture Leads Choice
Question: According to the surgical report for a knee resection, a patient diagnosed with ... Read more
Reader Question:
Justify 82310 and 82330 Together
Question: An endocrinologist client sometimes orders total calcium and ionized calcium tog... Read more
Reader Question:
83540/83550 Work Together for Transferrin Saturation
Question: Will Medicare pay for both CPT 83540 and 83550 on the same date of service?Geor... Read more
Reader Question:
88312 Spotlights PAS Stain
Question: The pathologist examined a toenail biopsy and also performed a PAS stain. The pa... Read more
You Be the Coder:
Determine Method for Molecular Tissue Prep
Question: Our pathologists often perform EGFR, KRAS, and BRAF molecular analyses. In addit... Read more
CCI 18.2:
87501-87502: Influenza Virus Typing Trumps Lab Procedure Codes
See why reporting new bundles together was already noncompliant. Following an April Co... Read more
CPT® 2013 Preview:
Brace for Molecular Diagnostics, HLA, Microbiology Changes, and More
MAAA brings new 'algorithm' category.Even more than in 2012, you need to get ready for lot... Read more
Regulation:
See What Supreme Court ACA Ruling Means for Your Lab
You may experience short-term 'preventive care' bonus.Now that the Supreme Court has uphel... Read more
ICD-10:
J09-J11 Identify More Specific Influenza and Comorbidities
Lose ICD-9 2009 H1N1 reference. Influenza reporting gets more specific once you quit u... Read more
Reader Question:
Don't Assume Special Stain
Question: Our pathologist evaluates a stomach resection from a sleeve gastrectomy performe... Read more
Reader Question:
Follow Payer Guidance for Colon Biopsy
Question: When our pathologist examines a colon biopsy from a screening colonoscopy (tur... Read more
You Be the Coder:
Match Pap Screening and Interpretation
Question: When our lab gets requests for a Pap test ordered with V76.2 , I've been told th... Read more
Pathology/Lab Coding Alert:
Missing Polyp/Fibroid Distinction Could Cost You Hundreds
3 scenarios show the way to accurate pay. You use the same procedure code for a uterine fi... Read more
Independent Lab:
3 Tips Ensure You're Ready to Report POS Correctly This Fall
Expect more 22 and 21, fewer 81 claims.Independent labs got a reprieve from place-of-servi... Read more
ICD-10:
N84 Merges ICD-9 621 and 622 Polyp Codes
Follow 'location' to choose the right code. Uterine polyp reporting gets much ... Read more
ICD-10 Sentinel:
Scrutinize AMA and Community Reaction to Implementation Delay
Watchful waiting will keep your lab ready. While you're waiting for CMS to make a ... Read more
Reader Question:
Ask Payer for G0364, 38220 Distinction
Question: Should I report G0364 or CPT 38220 for bone marrow aspiration and biopsy at the... Read more
Reader Question:
Count Drug Classes and Procedures
Question: We perform a seven drug-class test by immunoassay (amphetamines, barbiturates, b... Read more
Reader Question:
Abide by Contractual Fee Schedule
Question: Our lab changed the type of kit we use to test for bilirubin in whole blood. The... Read more
Reader Question:
80500: Meet 'Consult' Requirements
Question: If a physician requests a review of his diagnosis based on patient history, clin... Read more
You Be the Coder:
Understand Method to Code HER2/NEU
Question: Our pathologists use a billing template to check off what tests were done, fil... Read more
Breast Case:
Track Each Test Phase to Boost Breast Specimen Pay
Avoid pitfalls at each pathology exam stage. When a patient advances through multiple diag... Read more
ICD-10:
D05: Breast Cancer 'In situ' Expands Beyond 233.0
Update ER/PR status codes, too. You'll face significant changes in how you report ... Read more
Clinical Lab:
81000-81015: 3 Tips Drive Proper UA Code Selection
Avoid QW for PPMP labs.Urinalysis (UA) might be one of your lab's most frequently-ordered ... Read more
Molecular Pathology:
83890-83914: AMA Takes Steps to Delete Codes for 2013
Genetic test modifiers and array codes may go, too.Despite 101 new CPT® 2012 codes, ... Read more
Breast Case:
Don't Miss Ancillary Service Charge for ER/PR
Catch 'status' diagnosis codes.After the pathologist's work outlined in "Track Each Test P... Read more
Reader Question:
Beware Multiple Colon Biopsies
Question: Our pathologist received a specimen container labeled, "multiple colon biopsies,... Read more
Reader Question:
Master Anti-Markup Rule
Question: Medicare requires participating providers to indicate on the claim form in Box 2... Read more
Reader Question:
Don't Overlook 'Reason for the Test'
Question: Our lab sometimes receives orders from a client for a "pre-procedure workup" inv... Read more
You Be the Coder:
Normal Tissue Earns Ordering Diagnosis
Question: The pathologist examined a colon biopsy from a patient having a diagnostic colon... Read more
Skin Specimens:
88304-88305: Make Sure You Don't Upcode for Cancer
Stick to skin-origin codes regardless of depth or size. No one's happy reporting a skin co... Read more
ICD-10:
C43, D03: Two Families Replace 172 for Melanoma
Watch for more specific site options, too.Don't slack off with your ICD-10 preparations ju... Read more
CPT® 2012 Cytology:
88107: You Won't Miss the Missing Code
4 tips simplify your non-gyn cytology coding.Just remember four specific rules about codin... Read more
ICD-10 Delay:
Build 1 Extra Year into Your ICD-10 Change-Over Schedule
But don't count on the delay quite yet, expert warns. You'll have until Oct. 1, 2014 (inst... Read more
Compliance:
Check Out This Stark 'Physician Self-Referral Law' Update
Exceptions only apply in specific scenarios.If anything keeps pathologists with ownership ... Read more
Reader Question:
Pick Units or Modifier For Multiple Specimens
Question: I'm getting conflicting instructions about how to report multiple units of "like... Read more
Reader Question:
Don't Miss HIPAA 5010 Reprieve
Question: I heard that there's been another delay for HIPAA 5010 enforcement. Is that true... Read more
Reader Question:
Distinguish Uterus and Ovaries for Separate Pathology
Question: The surgeon submitted a hysterectomy in three separate containers identified as ... Read more
Reader Question:
Get Specific Orders for Heart Labs
Question: A cardiologist ordered "CVD markers" for a patient presenting with chest pain. W... Read more
You Be the Coder:
Grasp Leiomyoma Exceptions
Question: Please help clarify how to code intramural leiomyoma findings in a uterus specim... Read more
CCI Policy Manual:
G0416-G0419: Mark 5 Prostate Biopsies as the Magic Cutoff For 88305
Method, not number, should lead code choice. Quarterly updates aren't the only way that Me... Read more
ICD-10 Sidebar:
600 to N40: Expect Fewer Enlarged Prostate Code Choices
Cyst moves to different family. When you start getting test orders under ICD-10 with enla... Read more
Place of Service:
81 is Out: Claim POS Based on Patient Location
Expect "facility" payment to impact your bottom line.With a last-minute CMS announcement t... Read more
Legislation Update:
Prepare for Sunset of TC 'Grandfather' Arrangements
Accept short-term MPFS pay rescue.The "Middle Class Tax Relief and Job Creation Act of 201... Read more
Reader Question:
Check Payer Rules for IHC
Question: Our lab processed a lymph node biopsy for a patient with melanoma. We stained bl... Read more
Reader Question:
Use Lab Protocol to Establish Urine Culture Order
Question: We know that Medicare is reviewing urine reflex cultures, and we're wondering if... Read more
Reader Question:
Follow Method to Choose HPV Code
Question: Our lab started receiving specimens from an otolaryngologist client for HPV test... Read more
Reader Question:
88321: Don't Double Dip for IHC
Question: When our pathologist consults on a case that includes immunostain slides, which ... Read more
Reader Question:
82731: Analyte Leads Code Choice
Question: Our lab has started performing a fetal fibronectin test that an OB orders to ass... Read more
You Be the Coder:
Distinguish 'Specimen' Vs. 'Site' for Touch Preps
Question: If our pathologist performs intra-operative touch preps on two separate breast b... Read more
Molecular Pathology:
83890-83914: Keep On Stackin' in 2012
Heed payer guidance for new MoPath codes -- some may surprise you. With Medicare paym... Read more
ICD-10:
V84.0x Involves Simple ICD-10 Crosswalk
Apply the same BRCA positive rules when the codes change. You won't see "BRCA... Read more
Put a Fork in Genetic Test Modifiers
Rarely used; gone for good?Remember those two-place genetic testing modifiers that first a... Read more
Molecular diagnostics:
2 Steps Master Molecular Stacking Codes
Don't forget interpretation charge.You'll need to use them for at least the rest of this y... Read more
ICD-10:
Delay Gives You More Time to Implement ICD-10, HHS Confirms
With no new date in sight, press on with your lab's preparation.Your target for ICD-10 imp... Read more
Reader Question:
Remember CLIA Status Modifier
Question: We're a CLIA-waived lab performing the NMP22 test by Alere. How should we ... Read more
Reader Question:
Pathology Findings Lead Dx
Question: Our pathologist examined a biopsy from a screening colonoscopy that the physicia... Read more
Reader Question:
Beware PhD 'Interpretation'
Question: Our laboratory recently started performing a new molecular test for CF. The test... Read more
Reader Question:
88387 Bundles Baffle Coders
Question: The pathologist dictates, "Lymph node segregated from breast tissue for extensiv... Read more
Reader Question:
Check if 'Panel' is CPT® Defined
Question: What are the correct CPT codes for Celiac Panel and Celiac Infant Panel?Kentucky... Read more
You Be the Coder:
'Cocktail' is in the Procedure
Question: I've heard that if we use two IHC antibody stains on a single slide, we can no l... Read more
CCI 18.0:
87389: Pick Just 1 HIV Test Code or Risk Denials
Update bundles for cytology, special stains. Just as you're starting to use CPT&r... Read more
Catch Up Your Outpatient Edits to CCI 18.0
Counting on version 17.3 will put you behind.If you're used to ignoring new CCI edits for ... Read more
Newsbrief:
Same Code Assignment Could Cause ICD Confusion
Some conditions change classification.Ready or not, here it comes. More changes came down ... Read more
CCI Policy Manual:
83704: Look for NMR Lipoprotein Limits and Opportunities
Update your transfusion medicine guidelines, too.You always watch to see how Correct Codin... Read more
Reader Question:
Prep Your ICD-10 Breast Specimen Coding
Question: Our pathologists examine lots of breast cases, so we're trying to prepare for di... Read more
Reader Question:
85060: Know Medicare Inpatient Restriction
Question: Medicare doesn't pay for 85060 for outpatients. Can I submit this code with a mo... Read more
Reader Question:
88305: Acknowledge Cell Block Units Restriction
Question: The pathologist interprets two FNA specimens -- one from a nodule in the ri... Read more
Reader Question:
KOH Test Stands Alone
Question: Our lab receives a toenail excision with some attached skin for a fungal test. W... Read more
You Be the Coder:
Find Dividing Line for ISH Codes
Question: When our lab performs ISH procedures, we have PhD scientists who give the result... Read more
CCI Policy Manual:
88342, 88360-88361: Report IHC Per Specimen for Medicare Beneficiaries
Update your microdissection guidelines, too. Just when Correct Coding Initiative (CCI) pol... Read more
ICD-10:
185 Entails Simple ICD-10 Crosswalk
Apply the same PIN rules even when the codes change.If you don't have any trouble using th... Read more
Confirm FNA Unit of Service for Medicare
Lesion and evaluation episode constrain coding.If you understand how to report your pathol... Read more
HIPAA Compliance:
Get Ready for Updated, Aggressive 5010 Timeline
You might not have until March 31.You thought you wouldn't face enforcement action regardi... Read more
Physician Fee Schedule:
See How Medicare's '3-Day Payment Window' Could Impact Your Lab
Ownership is the key for bundling rule.Did you know that one of the least publicized chang... Read more
News brief:
Expect 2-Month Medicare Payment Reprieve
Hang on to 'grandfather' exception, too.You won't face a 27 percent Medicare pay cut start... Read more
Reader Question:
Don't Forget New CTC Code
Question: Our lab performs the CellSearch® test to evaluate circulating tumor cells ... Read more
Reader Question:
38220-38221 Face Bundling Restrictions
Question: When our pathologist examines a bone marrow aspirate and bone marrow biopsy, our... Read more
Reader Question:
Distinguish 2 CCI Edit Files
Question: Our lab performed a calcium test, and later the same day, the physician ordered ... Read more
You Be the Coder:
TC/26 Not For Every Code
Question: Our facility billed the global charge for 84165, but then the pathologist, who i... Read more
CPT® 2012:
81200-81408: Payment Hurdles Postpone New Molecular Diagnostics Codes
Keep using 83890-83914 for most payers. Don't expect 101 new CPT® molecular diagnost... Read more
Physician Fee Schedule 2012:
Steel Yourselves for 27 % Medicare Conversion Factor Cut
Plus: Physician signatures, cytology rates on the line.Welcome to another round of tense w... Read more
CPT® 2012:
Get All the Pay You Deserve -- Code Per Block for Special Stains
88312 unit change could earn you $107 or more.The American Medical Association (AMA) has c... Read more
CPT® 2012:
Clip-And-Save: Identify New and Deleted Codes That Impact Your Lab
Use this at-a-glance tool for accurate 2012 coding.Get a preview of new and deleted CPT�... Read more
Reader Question:
Check Out CMS Website for CLIA Details
Question: We are a CLIA waived lab. How can we find out if a specific test kit is somethin... Read more
Reader Question:
ICD-10 Prep is Different for Paper Claims
Question: If we file paper claims to Medicare, will the claims form change once we begin u... Read more
Reader Question:
Ensure Constituents for Full Urinalysis
Question: Our lab performed a macroscopic urine test, but due to color interference, we co... Read more
Reader Question:
Use Modifier 22 When Extra Work Warrants
Question: Our pathologist examined a very large lipoma located primarily in the upper back... Read more
You Be the Coder:
Break Out Components for Evocative/Suppression Payment
Question: I've looked on the Clinical Laboratory Fee Schedule for pricing for Calcitonin s... Read more
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