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Pathology/Lab Coding Alert

CPT® 2017:
84410 Solves Bioavailable Testosterone Coding Conundrum
Don’t settle for ‘total’ and ‘free’ coding options. If y... Read more
Zika Update:
Stay Abreast of Coverage, Diagnosis, and Blood Bank Changes
Distinguish symptoms versus infection. From ICD-10 to CMS to the Food and Drug Adminis... Read more
Hospital Lab:
Do Your Part for 'Hospital Readmissions Reduction'
Leverage test results to predict risk. If you never thought about how your hospital la... Read more
Reader Question:
Choose Eye Codes With Specimen and Laterality Details
Question: Our pathologist examined an eye enucleation specimen with a small piece o... Read more
Reader Question:
N76 Brings Organism Conundrum for Wet Mount/KOH Tests
Question: The lab performs a wet mount and KOH test for a vaginal smear from a pati... Read more
Reader Question:
Capture CMV Test and Diagnosis
Question: The clinician performs a flexible bronchoscopy with transbronchial biopsy... Read more
You Be the Coder:
Look to CLFS, MACs for MAAA Pricing
Question: We read in a past issue of Pathology/Lab Coding Alert [Vol. 14, No. 3] th... Read more
CPT® 2017 Lab Preview:
Expect Genomic Sequencing and MAAA Code Additions
Watch CMS for final pricing decisions. Here’s the scoop on new 2017 clinical lab... Read more
Anatomic Pathology:
Avoid This $312 Sentinel Lymph Node Mistake
Ensure that you’re up-to-date on IHC rules. Your pathologist receives two sentin... Read more
ICD-10:
Update Reporting Carcinoid Tumors, Viral Hepatitis Carrier, and More
Use 2017 codes as of October 1. Ever since you started using ICD-10-CM for diagnosis c... Read more
Reader Question:
Find PAMA Lab Reporting Answers With CMS Resources
Question: I’m trying to figure out if our lab has to report data about lab te... Read more
Reader Question:
Look for Distinct EGD Specimens
Question: The pathologist received tissue from an EGD procedure identified by site:... Read more
Reader Question:
Stick With 85025 for CBC and Automated Diff
Question: When we run a complete blood count with automated differential, sometimes... Read more
Reader Question:
Loosen Your ICD-10 Alpha Numeric Expectations
Question: I’d been taught that ICD-10 diagnosis codes have three to seven cha... Read more
You Be the Coder:
Focus FISH Procedure Codes
Question: Our lab is performing a method new to us, which uses a dual-color in situ... Read more
CPT® 2017:
Welcome Drug-Screen Code Update -- Again
Get payers on the same song sheet. If you’re still frustrated because you have t... Read more
CLFS:
Look for Definitive Drug Test Repricing
‘Pay more,’ stakeholders say. Definitive drug test codes G0480-G0483 were ... Read more
Pathology Quiz:
Test Your Myomectomy Coding Skills for Clean Claims
Pick correct procedure and diagnosis codes. Trying your hand at a coding scenario can... Read more
Security Tip:
Dodge "Malvertising" Disaster With These Steps
Beware third-party browser extensions. Ever heard of “malvertising”? You s... Read more
Pathology Quiz Answers:
Check Your Fibroid Procedure and Diagnosis Codes Here
See how many specimens you have. Now that you’ve decided how to code the case d... Read more
Reader Question:
Select Modifier for Bundled Cultures
Question: We received a request for urine culture (87086) and expressed prostatic s... Read more
Reader Question:
Keep pH Part of Urinalysis
Question: When our physician office lab does a urinalysis, we use a kit that requir... Read more
Reader Question:
'Needle' Specimen Leads Pathology Code Choice
Question: We have a disagreement in our office. If the pathologist examines a needl... Read more
Reader Question:
Choose Specific MPO Code
Question: We have clients who order MPO blood tests following troponin-negative tes... Read more
You Be the Coder:
'Skin' Determines Procedure, Diagnosis Codes
Question: The pathology report documents a 2.1 cm “cherry hemangioma,” ... Read more
PAMA Finalized:
Get Ready for Lab Price Reporting -- And CLFS Overhaul
One way or another, the change will impact your lab. If you’re an “applica... Read more
Anatomic Pathology:
Capture 2 Kidney Specimen Exams for Nephrectomy Case
Don’t miss frozen section charge, either. When your pathologist receives kidney ... Read more
ICD-10-CM:
Avoid Dx Denials When 'Grace Period' Ends This Fall
Count on specificity, 2017 code change awareness. You may recall how relieved you wer... Read more
Reader Question:
Use Modifiers With Caution to Avoid Denials
Question: I’ve recently begun coding for our lab because we’re short st... Read more
Reader Question:
Don't Miss Decalcification Charge
Question: The pathologist examined a “paranasal sinus osteoma” specimen... Read more
Reader Question:
Document Factors Influencing Health
Question: A physician client ordered an HIV test for a patient with “high ris... Read more
You Be the Coder:
Follow Rules to Override HPV Bundle
Question: In addition to a Pap smear, our lab performed an HPV test for high risk t... Read more
Zika Virus:
Look Ahead to CDC and Commercial-Lab Zika Testing
Understand protocols and coding pitfalls. Travel-related Zika virus infections have c... Read more
ICD-10:
Distinguish Zika Exposure, Symptoms, Infection
Watch for pregnancy impact on coding. You should understand Zika testing after reading... Read more
Anatomic Pathology:
Don't Make This $400 Tongue Specimen Mistake
Code ‘lesion excision’ based on purpose. Coding for tongue specimens shou... Read more
HIPAA Audit:
Strengthen Your Plan for Phase 2 Audit Focus
Use protocol tool even if you don’t face audit — this time. Even if your lab ... Read more
Reader Question:
Focus DCIS Coding
Question: If the pathology report indicates “ductal carcinoma in situ,”... Read more
Reader Question:
Code Highest Level Cytology
Question: The cytopathology lab received a bladder washing specimen, reviewing a di... Read more
Reader Question:
Report Unit of Service per Test
Question: We perform a single PCR test that can identify and distinguish between Ba... Read more
You Be the Coder:
Greet Screening Pap and HPV Test Code
Question: If we perform a screening Pap smear and high risk HPV test for a Medicare... Read more
Cytopathology:
Don't Miss IHC and More for This Lung FNA Case
Focus on diagnosis, too. Follow the steps performed by the pathologist and lab analyst... Read more
ICD-10:
Jump On Diagnosis Changes Coming This October
The annual update process is back in full swing. You’ve had a five-year code fre... Read more
Outpatient Rules:
Submit to OPPS Lab and Pathology Packaging
Follow status indicator for separate pay. As the Outpatient Prospective Payment System... Read more
HIPAA:
Jump on Business Associate Tracker Tool
Use HHS template to make your job easier. If you’re like most labs and find keeping... Read more
Reader Question:
Follow Pathologist's Lead in Code Selection
Question: How should I code a left ovary struma ovarii if the pathologist notes tha... Read more
Reader Question:
Focus on C. difficile Test Method
Question: The physician ordered a Clostridium difficile test for a patient exhibiti... Read more
Reader Question:
Remember Sequestration Cuts
Question: Are our pathologist’s Medicare payments still subject to the two pe... Read more
Reader Question:
Define 'Breach' to Recognize Problem
Question: An employee at our lab accessed records without a legitimate reason. He d... Read more
Reader Question:
Not All Hair Exams Are Equal
Question: We received a hair specimen that the pathologist evaluated under the micr... Read more
You Be the Coder:
Check Strep Method, Recurrence for Correct Codes
Question: When our lab preforms a strep test from a throat swab for a patient that ... Read more
CCI 22.1:
Beware New 'G-Code' Drug Screen Bundles
Method and UA codes off the table. After assigning seven, new HCPCS Level II “G&... Read more
Medicare Billing:
See How POS 19 Could Impact Your Pathology Pay
Understand “off-campus” clinics. You should currently be using one new and... Read more
Medicare:
Look for MIPS to Centralize Quality Reporting
Pay for performance here to stay. When the Medicare Access and CHIP Reauthorization Ac... Read more
Reader Question:
Translate Bethesda FNA to ICD-10
Question: What ICD-10 code would you use for a thyroid FNA of a nodule that has the... Read more
Reader Question:
Use 83721 for Reflex LDL
Question: I noticed in an earlier reader question that you said we can’t sepa... Read more
Reader Question:
Capture Multiple Hydrocele Exam Steps
Question: Our pathologist examined a cytology specimen obtained when the surgeon dr... Read more
You Be the Coder:
Don't Miss Lipoma Difference
Question: Our pathologist examined a right breast biopsy specimen and diagnosed the... Read more
Anatomic Pathology:
Don't Miss the $74 Surprise in This Hemorrhoidectomy Case
Let diagnoses lead your procedure code choice. The surgeon may have described a hemorr... Read more
Fungal Disease:
Get Histoplasmosis Analysis and Diagnosis Tips Here
Signs and symptoms may indicate testing need. Diagnosing histoplasmosis infection can ... Read more
MPFS Pay:
Blink and Miss Conversion Factor Decline
Error warrants small adjustment.  If you weren’t paying close attention, yo... Read more
PAMA Update:
Await CMS Final Rule Before Reporting Your Lab's Data
CLFS repricing on hold for now. With the proposed-rule deadline upon us for reporting ... Read more
Reader Question:
Reserve QW for CLIA-Waived Labs
Question: Please help settle a disagreement in our office — as a lab with a C... Read more
Reader Question:
Watch for "Complete Class" HLA Code
Question: Our lab performs high resolution HLA Class I typing, sometimes testing fo... Read more
Reader Question:
Keep Up With Sequestration Cuts
Question: In looking at our pathology payments, it appears that we’re still g... Read more
Reader Question:
Learn When HIPAA Trumps State Law for Medical Record Fee
Question: What should we do if our state law is different from HIPAA regarding fees... Read more
You Be the Coder:
Beware Date-of-Service Edits
Question: The pathologist examined specimens from a double mastectomy, identifying ... Read more
Anatomic Pathology:
Focus Your Liver Resection Coding With 4 Easy Steps
Distinguish blocks, specimens for stains. When your pathologist examines a liver resec... Read more
Clinical Laboratory:
Keep your H. Pylori Test Coding On Track With Our Expert Tips
Heed payer coverage rules to get the pay you deserve. When a patient presents with per... Read more
Reimbursement:
Boost Your Lab's Pay With Claims Management Strategies
Keep your AR up-to-date. You’ve stayed on top of the coding changes, educated yo... Read more
Reader Question:
Date of Service Trumps Claim Line Edits
Question: We’ve been involved in testing for enteric adenoviruses types 40 an... Read more
Reader Question:
Compare Cyst Drainage, FNA
Question: The pathologist received a pelvis cyst needle-aspiration specimen and exa... Read more
Reader Question:
Distinguish CRP, hs-CRP Tests
Question: What are the clinical indications for C-reactive protein test versus high... Read more
You Be the Coder:
PIN Grade Guides Prostate Dysplasia ICD-10 Code
Question: The pathology report documents dysplasia of prostate. How should we repor... Read more
CCI 22.0:
Focus You Q1 Coding With This Edit Update
Expect bundles with most new 2016 codes. With 57,161 new edit pairs — roughly 10... Read more
News You Can Use:
Compulsory Lab and Pathology 'Packaging' Part of OPPS
Molecular pathology exempt, in most cases. You’ll find more and more lab and pat... Read more
OIG Alert:
Expect Watchdog Actions to Target Your EHRs
Watch your clinical lab payments, too. If you thought HIPAA enforcement was tough last... Read more
Reader Question:
Anticipate HIPAA Illegal Immigrant Question
Question: If our lab reports someone who is an illegal immigrant, is this a violati... Read more
Reader Question:
Watch for HAAb Antibody Class
Question: Our lab performs two tests for Hepatitis A antibody — one for IgG c... Read more
Reader Question:
Get Valid Provider Signatures
Question: I’m having trouble getting my pathologists to sign their claim form... Read more
Reader Question:
Turn to 88333 Family for Intraoperative Touch Prep
Question: Our pathologist received a skin lesion excision specimen for which the su... Read more
You Be the Coder:
Zero in On Diagnosis For This Prostatectomy Case
Question: Please help with the ICD-10 coding on the following multiple specimens re... Read more
Coverage Policy:
Focus on 7 New Drug Test 'G' Codes for Medicare
See how the change impacts your bottom line. Labs had to wait in suspense almost to th... Read more
Physician Fee Schedule:
Greet 2016 Fee Changes That Could Jumpstart Your Pay
Check out these steep IHC and ISH increases. Unlike some other specialties, things are... Read more
HIPAA:
Beware: Your Breach Report May Backfire
Best defense is good compliance plan. If you experience a reportable privacy breach, y... Read more
Reader Question:
Watch 'Glucose' Charge for Tolerance Test
Question: I’ve found conflicting answers about how to bill for a Glucose 2 ho... Read more
Reader Question:
Identify Factors Leading to Lab Test with 'Z' Codes
Question: What diagnosis code would I use if the patient is requesting lab tests to... Read more
Reader Question:
Understand CLFS Re-Pricing
Question: I’ve heard that PAMA requires Medicare to re-figure all clin lab fe... Read more
Reader Question:
Focus on FOBT Coding
Question: We received an order for a fecal specimen collected during a DRE for a pa... Read more
You Be the Coder:
Zero In on ICD-10 Flu Diagnosis
Question: How can we report the diagnosis of swine flu influenza in ICD-10-CM? Oh... Read more
Cervical Cancer Screening:
Update Your HPV Testing Protocol
Every five years passes CMS muster. If your lab is stuck in the biennial Pap/reflex to... Read more
PAMA Action:
Meet the Proposed CLFS Pricing Rule
Lab reporting starts January 1. Finally — the rule for re-valuing the Clinical L... Read more
ICD-10:
Keep Up the Good Work -- Smooth Transition Underway
CMS reports 90 percent claims acceptance rate Maybe the sky didn’t fall when we ... Read more
Reader Question:
Don't Double Dip for Lab Method
Question: Our lab performs a procedure to assay non-drug analytes that involve... Read more
Reader Question:
Pay Attention to ICD-10 Combination Codes
Question: Our lab performed a culture ordered for a patient with a diagnosis of sep... Read more
Reader Question:
Zero In on Lipid Order for Proper Coding
Question: A physician ordered cardiovascular lipid panel screening. How should I co... Read more
Reader Question:
Ignore 'Direct' or 'Indirect' for Immunofluorescence Studies
Question: I understand that coding for immunofluorescence studies to aid in the dia... Read more
Reader Question:
Look for SSN Protection
Question: I’ve heard that Medicare is removing the patient’s Social Sec... Read more
You Be the Coder:
Check Out This Lung Case
Question: Our pathologist evaluated a frozen section of a lung wedge biopsy during ... Read more
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