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Pathology/Lab Coding Alert
Pathology/Lab Coding Alert
Pathology/Lab Coding Alert - 2015; Volume 16, Number 12
2016 Update:
Expect 2-Tier Drugs-of-Abuse Reporting for Medicare
Continue to ignore CPT® drug codes. The two proposed “G” codes for Med...
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Toxicology:
Understand Screening vs. Confirmatory Testing
Grasp ‘definitive’ terminology, too. If your lab performs toxicology testi...
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HIPAA Compliance:
Bust These 4 PHI Disclosure Myths
Patients can request lab results. There’s such a thing as protecting “prot...
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Reader Question:
Learn Hemoglobin A1C Frequency Limitations
Question: We often get orders for hemoglobin A1C tests from physicians for patients...
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Reader Question:
Select Procedure Code for Soft-Tissue Mass
Question: Our pathologist received a specimen identified as a biopsy of a “so...
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Reader Question:
Change 'BPH' to 'Enlarged Prostate'
Question: The pathologist examines a prostate biopsy and diagnoses “benign pr...
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You Be the Coder:
Learn 'Unspecified' and 'Other Specified' ICD-10 Distinction
Question: We’ve observed that some codes we commonly used under ICD-9 don&rsq...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 11
CPT® 2016:
Preview Your Code Changes for Lab and Pathology With These 5 Highlights
Grasp changes for immunology, molecular studies, and more. The waiting is over &mdash...
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Drug Coding:
CPT® 2016 Pares Down Chromatography Choices
Changes compliment 2015 drug overhaul. By now, you should have adjusted to last years...
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ICD-10 Know How:
4 Steps Focus Neoplasm Coding
Look for clues in the pathology report. You’ve arrived — after years of pr...
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Neoplasm Coding:
Practice Your ICD-10 Cancer Coding With These Examples
Make sure you’re ready to use the tools for ICD-10 neoplasm coding that you read a...
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Reader Question:
Update Your Medicare Opt-Out Procedure
Question: Our pathology practice currently opts out of Medicare, and I heard that t...
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Reader Question:
Distinguish FNA, Cyst Aspiration
Question: The pathology report states that the specimen is an “FNA cyst aspir...
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Reader Question:
Follow Lab Method for Histoplasmosis Code
Question: The lab receives a blood specimen with a request for a test to “rul...
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You Be the Coder:
Count Bone Marrow Special Iron Stains
Question: The pathology report for a bone marrow case documents iron stains on bloc...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 10
Cytogenetics:
Marshal Pay for Microscopic Chromosomal Analyses
Differentiate molecular test codes. The current focus on explosive growth in molecular...
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ICD-10:
Distinguish 3 Forms of Trisomy 21
Focus on cytogenetic test results. Just one code (758.0, Down’s syndrome) w...
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PAMA Update:
Look into CLFS Pricing Reform Limbo
Guidelines miss June 30 mark. If you’ve been waiting with bated breath to learn...
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Reader questions:
Document More Detail for ICD-10 DCIS Diagnosis
Question: The pathology report indicates that the pathologist examined a breast bio...
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Reader questions:
Look to Mohs Codes for Dermatopathology
Question: The dermatopathologist removes a basal cell carcinoma from the central port...
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Reader questions:
Follow Carbon Isotope for Code Choice
Question: How should we code an H. pylori breath test? Georgia Subscriber Answe...
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You Be the Coder:
Clarify Bladder Biopsy vs. TUR Specimen
Question: The pathology report states that the specimen received is a bladder biops...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 9
Toxicology:
Expect Just Two Medicare Drug Test Codes for 2016
Agency fears overpayment for drugs-of-abuse testing. Billing for Medicare-beneficiary ...
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2016® Lab Code Preview:
Watch For Continued Molecular Test Expansion
Check with CMS for final pricing decisions. You can get the scoop on what new 2016 cl...
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ICD-10 Implementation:
CMS Offers Relief -- No Claims Denials in First Year
Don’t relax your lab’s preparation. If you can at least list an ICD-10 cod...
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Reader Questions:
Update PSA Coding for ICD-10
Question: What diagnosis codes should we use for screening and diagnostic prostate ...
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Reader Questions:
Check Specimen for IHC Codes
Question: We are still dealing with getting paid for some IHC staining tests done i...
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Reader Questions:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a direct...
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Reader Questions:
Report ER Findings, Too
Question: When the pathologist completes a malignant breast cancer case and has per...
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Reader Questions:
Avoid Signs and Symptoms With Definitive Diagnosis
Question: When billing codes that fall under the physician fee schedule, should pat...
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You Be the Coder:
Beware Coverage Frequency Limitations
Question: A physician ordered a weekly hemoglobin A1C test to monitor a patient for...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 8
Compliance:
Decipher Unbundling Tools With This Lung Case
You can stick with modifier 59 for now. When you’re up against Medicare’s ...
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ICD-10:
Location Drives Lung Cancer Diagnosis Changes
Laterality adds specificity. Coding for lung cancer won’t change too much when I...
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ICD-10:
Drive Home Key ICD-9 to ICD-10 Changes for Your Pathology Practice
Avoid this one GEM trap. Maybe you’re ready to transition smoothly to ICD-10 sta...
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ICD-9 to ICD-10:
Take These 3 Preparation Steps
Transition doesn’t end on October 1. With a firm understanding of the ICD-9 to I...
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Reader Questions:
Check Payers for Crohn's Antibody Test Coverage
Question: Our lab performs antibody testing for ASCA and ANCA to establish a differ...
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Reader Questions:
Look for HPV Screening Coverage
Question: I’ve heard that Medicare has started to cover screening tests for H...
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Reader Questions:
Don't Split Combination Code
Question: Our lab performs an automated urinalysis and a urine microscopy exam, but...
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You Be the Coder:
Focus on Specimens, Stains, for FNA Case
Question: Please help with coding for the following thyroid case: Pathologist receives...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 7
HCPCS Level II:
G0472 to the Rescue for Hepatitis C Screening
Don’t report additional lab test code. When your lab performs a test for Hepatit...
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ICD-10:
Support Medical Necessity for HCV Screening: Here's How
‘V’ codes move to ‘Z’ or ‘F’ codes for screening dia...
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Practice Management:
'Quality' Reporting - Get on Board or Lose Big Pay
Rewards and pay cuts hang in the balance for your pathology practice. PQRS, VBPM, and ...
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Reader Questions:
Avoid 'Self-Bundling'
Question: Our pathologist received a breast lumpectomy specimen, and a single axill...
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Reader Questions:
Use GZ as Last Resor
Question: Our lab performed a Pap test for a Medicare patient that exceeds the freq...
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Reader Questions:
Document Semen Analysis Service
Question: Our lab performs a polymorphonuclear neutrophils test for semen. I think...
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You Be the Coder:
Capture Each BAL Examination Step
Question: Following a positive TB skin test, the physician performs a BAL and sends...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 6
Case Study:
Clear 3 Hurdles in Colon Cancer Case
Capture each specimen to boost your bottom line. When your pathologist examines tissue fr...
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Medicare Funding:
Say Goodbye to SGR Once and For All
Keep focus on ICD-10, too. You’ve waited with bated breath for the last time t...
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ICD-10:
Check Out This Colon Polyp Coding Update
Document site to choose the proper code. You’ve read about ICD-10 coding for b...
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Compliance:
Prepare Your Lab For 5 HIPAA Trends in 2015
Expect state law to have a big impact. If you know you need to up your lab’s game f...
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Reader Questions:
Tie 'Request' to Consultation Code
Question: We received a paraffin block from an outside lab with a request to run repeat ...
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Reader Questions:
Match Lab Testing to CLIA License
Question: Our physician office lab is CLIA waived, so if we perform 83009 and 8667...
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Reader Questions:
Don't Approximate ICD-10 Codes
Question: I have seen lots of great ICD-9 to ICD-10 crosswalks, but it seems like there ...
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You Be the Coder:
Let Payer and Purpose Lead Your Drug Test Coding Choice
Question: Please explain how I should code a drug-test order for a patient on prescripti...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 5
CPT® 2015:
4 Tips Decode New GSP Codes
Check coverage and await gapfill pay decision. If your molecular lab performs genetic ...
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GSP Payment:
Look to Gapfill Genomic Pricing for Next Year
Ask payers for reporting/payment instruction. You have 21 new CPT® codes for &ldqu...
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ICD-10:
Expect Direct Crosswalk for Aortic Dissection
Specify thoracic or abdominal site Good news: Nothing changes but the number when you&...
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SGR Fix:
Manage Medicare Pay Cut Now
Senate may act after recess. It happened — April 1 came and went with no final C...
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ICD-10 Transition:
Use Testing Opportunities to Ensure You're Ready
Watch for July application. If you think your lab is ready for ICD-10 implementation, ...
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Reader Questions:
Get Familiar With Sperm Toluidine Blue Assay
Question: The lab received a sperm specimen and a request for a Toluidine blue assa...
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Reader Questions:
Abide by Specimen Definition
Question: We’re trying to code a pathology report with the following informat...
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You Be the Coder:
Multiple FISH Probes Define 'Multiplex'
Question:Could you please clarify the meaning of “multiplex” in codes 88374 ...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 4
Toxicology:
Ignore Massive CPT® 2015 Drug Coding Changes for Medicare
Choose from 28 new ‘G’ codes instead. Learning about the CPT® 2015 tox...
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ICD-10:
F11.2__ Adds Manifestation to Opioid Dependence Codes
You won’t need separate manifestation codes anymore. You can forget vague dru...
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Modifier Focus:
Maneuver Modifier 90 Pitfalls to Bill Referred Lab Tests
Payer rules call the shots. If you want or need to bill for clinical lab tests that yo...
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Reader Question:
Ensure Encryption to Avoid HIPAA Breach
Question: If our lab uses unencrypted email to send a report with a patient’s p...
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Reader Question:
Unravel IHC Block, Specimen Question
Question: How many immunohistochemistry stains should you charge for this case: two brea...
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Reader Question:
Capture Pay for Distinct Prostate Stains
Question: Our lab performs qualitative EGR and PIN-4 stains on a single prostate co...
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You Be the Coder:
Brush Up on Specimen DOS Rules
Question: Could you please explain the CMS date of service policy, especially the i...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 3
CPT® 2015 Toxicology:
Part 1: Hone Drug Coding With New Sections, Drug Lists
Find changes all the way to the chemistry section. No kidding — the CPT® 201...
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ICD-10:
Screening Drug Test Orders Use Many Diagnoses
Get ready for new options later this year. When your lab performs a screening drug tes...
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ICD-10 Prep
Remember that ICD-10 goes into effect Oct. 1 this year for Medicare, meaning that you&rs...
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CPT® 2015 Toxicology:
Part 2: Focus on Methods to Direct Your Drug Code Choice
Know your specimen source, too. New CPT® sections and new drug lists that you read...
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Physician Fee Schedule:
Follow Changing Payment Trail for Your Lab
The RVUs aren’t all you need to observe. As it turns out, things weren’t s...
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Reader Question:
Check for 'Repeat' or 'Bundle' Modifiers
Question: A physician ordered basic metabolic panel 80048 for a patient, and later ...
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Reader Question:
Distinguish Sperm Motility, Viability
Question: How should we code a sperm viability test known as an Eosin Y test? Is th...
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You Be the Coder:
Expand Keratoderma Choices in ICD-10
Question: Our pathologist received a skin specimen and wrote the diagnosis as &ldqu...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 2
2015 Medicare Pay:
See How Your Procedures Stack Up with PFS Winners, Losers
Expect more for pathology consultation. Depending on which codes represent high-volume...
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Final Rule:
Beware Potential 'Ides of March' Pay Cut
Only an act of Congress can save the day. You might be experiencing little change in M...
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ICD-10:
C64.1_ Chooses Sides for Renal Tumors
Learn ICD-9 189.x crosswalks. Just two codes describe kidney tumors and renal-pelvis t...
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Lab Management:
Solidify Your Compliance Plan in 2015 With These OIG Tips
Take 7 steps now to meet ACA standards. Making sure your compliance plan is in place s...
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Reader Question:
Check Age, Conditions, for HCV Screening
Question: A physician ordered a hepatitis C screening test for a Medicare patient w...
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Reader Question:
Don't Prioritize Mass of Uterus
Question: I’ve heard that the mass of a uterus is important for choosing the ...
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Reader Question:
85610 Works for Coumadin Monitoring
Question: A patient with deep venous thrombosis (DVT) is on Coumadin for blood thin...
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You Be the Coder:
Carefully Document Stages for Modified Mohs
Question: Please explain if we should use Mohs codes for the following case, or if ...
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Pathology/Lab Coding Alert - 2015; Volume 16, Number 1
Physician Fee Schedule 2015:
Revamp Prostate Biopsy Coding -- Again
G0416 alone could hurt your bottom line. CMS thinks your pathologist should get $227 l...
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PSA Fundamentals:
G0103 or 84153: Avoid Coding Missteps With By Knowing Reason for Test
Match diagnosis code to procedure code. When your lab gets a specimen with an order for t...
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ICD-10:
Follow the BPH Disappearing Act
You won’t find the term in the new diagnosis code set. If you can’t find t...
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Diagnosis Coding:
Follow These 3 Tips to Prepare for ICD-10
Zero in on common codes your lab uses. If you don’t want a rude awakening next O...
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Reader Question:
Use Interpretation Option for Certain Lab Tests
Question: When our pathologist receives a request for interpretation of a serum pro...
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Reader Question:
Specify Source for KOH Test
Question: Our lab received a skin scraping with a request to test for suspected sca...
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Reader Question:
88344 Fills Multiplex IHC Need
Question: How should we report our PIN4 triple stain under the revised IHC codes in...
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You Be the Coder:
Catch Up to Drug Test Code Changes
Question: I know the drug screen codes change in the latest CPT® update —...
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