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Pathology/Lab Coding Alert

CPT® 2019:
Embrace New FNA Extraction 'Guidance-Specific' Codes
Evaluation coding stays the same. When your pathologist extracts a fine needle aspiration... Read more
ICD-10-CM Quiz:
Tackle Diagnosis Coding for This GIST Case
Consider “behavior” to pick the right code. Test your diagnosis-coding prowess for th... Read more
ICD-10 CM Answers:
Check Your GIST-Case Diagnosis Code
Know ‘sarcoma' behavior. The short answer to this coding quiz is: C49.A3 (Gastrointesti... Read more
Compliance:
5 Tips Dodge Denials for Signature Errors
Avoid this common CERT pitfall. Perfect CPT® and ICD-10-CM coding might not be enough to... Read more
Reader Question:
Match Panel-Code Test List
Question: Our lab received an order for blood electrolytes potassium, sodium, total calciu... Read more
Reader Question:
Look for Fee Schedule Updates
Question: What conversion factor and program changes should I expect from the 2019 Medicar... Read more
Reader Question:
Monitor Procedure-Code Deletion Date
Question: We had a case that involved a procedure performed in late December that we did n... Read more
You Be the Coder:
See How Diagnosis and Bundling Impact Ovarian Case
Question: The pathologist evaluates a left-salpingo-oophorectomy specimen that the surgeon... Read more
CPT® 2019:
Update Chemistry Section with Direct-Measure Cholesterol Code
Catch new code for DHT, too. If your lab sometimes performs direct-measure tests for lipo... Read more
2019 Physician Fee Schedule:
Reap Rewards for IHC 88360-88361 Correct Coding
Hit the payday jackpot for technical component. The proposed 2019 Medicare Physician Fee ... Read more
Disaster Claims:
Focus Lab-Test Coding for Hurricane Florence Victims
Look for Medicare waivers and more. If you're a lab operating in the middle of a disaster... Read more
Reader Question:
Mohs Requires 1 Physician, 2 Procedures
Question: Our hospital lab has an arrangement with a local dermatologist to perform tissue... Read more
Reader Question:
Strep Group Dictates PCR Test Codes
Question: How should we report the service when our lab tests for Strep group A and group ... Read more
Reader Question:
Honor Patient PHI Request
Question: Do you have any advice to help us protect our patients' health information, if t... Read more
You Be the Coder:
Distinguish 'Separate' or 'Repeat' Test Modifiers
Question: When should we use modifier 91 instead of modifier 59?   Kentucky Sub... Read more
CPT® 2019 for Labs:
Preview Numerous PLA and Tier 1 Molecular Pathology Codes
Update some chemistry options, too. You need the scoop on 2019 clinical laboratory CPT® ... Read more
ICD-10-CM 2019:
Master New Infection Code Options for Wound, Appendix, Gallbladder
Remember the ‘X' placeholder. If you code for a pathology practice or clinical laborato... Read more
Practice Management:
Get the Scoop on Medicare Facts You Need to Know
Pathologists may choose to participate. Whether pathologists in your practice are new or ... Read more
Reader Question:
Check PLA Codes for Lab Tests
Question: Our lab is performing a new presumptive drug-screening test, typically for 10 dr... Read more
Reader Question:
Follow HIPAA Beyond the Grave
Question: Is our lab required to maintain a patient's private health information after the... Read more
Reader Question:
Beware HbA1c Frequency Guidelines
Question: We have a clinician who orders HbA1C testing every month for every diabetes pati... Read more
Reader Question:
Recognize Medicare Participation Levels
Question: If our pathologist is non-participating with Medicare, I thought that meant he c... Read more
You Be the Coder:
Get Breast Case from Procedure to Diagnosis
Question: For a 31-year-old female patient, our pathologist examined a breast lumpectomy c... Read more
ICD-10-CM Update:
Mark Changes for Coding Neoplasms, Metabolic Disorders, and More
Turn to op report for tumor site. As a pathology or lab coder, maybe you've sometimes wis... Read more
ICD-10-CM 2019:
Don't Miss 'Upper,' 'Lower' Eyelid Distinction
More than 40 new codes specify eyelid cancer. You read about the following new eyelid seb... Read more
Anatomic Pathology:
Leap Across Lymph-Node Coding Pitfalls in 5 Steps
Identify biopsy, resection, or bundled. Missing a lymph-node-resection exam could cost yo... Read more
Reader Question:
Watch the Calendar or Lose Pay
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
Reader Question:
Consider Gestational Age of Fetal Specimen
Question: A case involved the pathologist performing microscopic exam of a spontaneous abo... Read more
Reader Question:
Recognize 'Scalp,' 'Forehead' Dividing Line
Question: Should I use C4A.39 for Merkel cell carcinoma found only on the scalp, since C4A... Read more
You Be the Coder:
Capture 2 Parts of CTC Service
Question: How should we report the lab analysis and pathologist interpretation for a blood... Read more
Clinical Lab:
Obey Rules and Restrictions to Get Thyroid-Test Claims Paid
Ensure medical necessity for coverage. If your lab performs blood tests for thyroid funct... Read more
Wound Infection:
Master Pressure Ulcer Culture and Dx Coding
Don't miss tips on site and stage. When a clinician suspects an infection in a decubitus ... Read more
Compliance:
Steer Clear of OIG Action on Lab-Test Fraud
High costs and usage spur fed oversight. The 25 most-frequently ordered lab tests are und... Read more
Reader Question:
Learn New QPP Lingo
Question: I've recently heard the term “promoting interoperability” regarding the QPP ... Read more
Reader Question:
Tier 1 May Include Additional Variants
Question: We're providing an NRAS molecular test that yields results for multiple variants... Read more
Reader Question:
Show Signs and Symptoms Their Place
Question: Our pathologists frequently get specimens from physicians with reports that list... Read more
You Be the Coder:
Provide Antibody Info for 86255 Payment
Question: We received a denial for 86255 stating that we needed to provide documentation o... Read more
Pathology Consultation:
Break 3 Intraoperative-Consult Myths
Check out +88334 restrictions. Serious pitfalls greet you on the road to coding your path... Read more
ICD-10-CM:
Master Neoplasm Coding With Documentation, Definition, Deduction
Never make a guess for code assignment. When you look at the ICD-10-CM neoplasm table, yo... Read more
Compliance:
Follow 4 Tips to Keep Feds Away
Watch for medical necessity and more. You can fend off fraud and abuse accusations for yo... Read more
Reader Question:
Say Yes to MPO and CRP
Question: We have a cardiology client who orders serum CRP and MPO follow-up testing for p... Read more
Reader Question:
Use Pathologist's Diagnosis for Code Selection
Question: The pathologist examined a resection from a patient's left forearm that the surg... Read more
Reader Question:
Understand HbA1C Frequency Limits and Fee Schedule Rates
Question: Our lab performs monthly HbA1C testing for several patients ordered by one speci... Read more
Reader Question:
Don't Overstate or Understate Known Diagnosis
Question: The pathologist examined a fine-needle aspiration from the spleen of a patient d... Read more
You Be the Coder:
Bill +88311 With Primary Service Code
Question: During a chart audit, we were told that a specific case did not support billing ... Read more
CPT® 2018:
See How PLA Options Stir the Drug-Test Coding Pot
Recall presumptive, definitive difference and hierarchy. At first glance, you might think... Read more
Drug Testing:
Abide by Drug-Test Performance Parameters
Frequency and validity could trip you up. When your lab performs drug tests, you must fol... Read more
Compliance:
See How Medicare Texting Guidance Impacts Your Lab
Learn different rules for orders and results. When physicians order tests from your lab, ... Read more
Reader Question:
Focus Vitamin D Coding
Question: A physician ordered a test for serum Calcidiol D2 and D3, which our lab performe... Read more
Reader Question:
Take Heed of FNA Smear Exam Bundles
Question: Our pathologist evaluated a direct FNA specimen smear for diagnosis, then furthe... Read more
Reader Question:
Turn to Specific Urine Cytology FISH Code
Question: To monitor bladder cancer patients for possible recurrence by detecting possible... Read more
Reader Question:
Classify AIDS, HIV in ICD-10-CM
Question: How do I know when to code for AIDS (B20), not HIV (Z21)? Codify Subscriber An... Read more
You Be the Coder:
Capture Each Part of Renal Case
Question: Our pathologist was called to the operating room to evaluate a kidney biopsy spe... Read more
Proprietary Tests:
Greet 10 New PLA Codes for Q2, 2018
AMA assigns codes for Borrelia tests and more. Even if you're just getting the hang of th... Read more
ICD-10:
Get Dx Coding Right for Urine Testing Medical Necessity
Target symptoms, site, condition, and more. Urinalysis and urine culture are commonly-ord... Read more
HIPAA:
Heed Enforcement Warnings for Security Rule Compliance
Put physical and virtual access on lockdown. Maybe you've avoided HIPAA enforcement actio... Read more
Reader Question:
Grasp This IHC Coding Riddle
Question: Our pathologist examined a breast biopsy and evaluated stained slides for ER, PR... Read more
Reader Question:
Distinguish Influenza Strains for Multiple 87400 Units
Question: Our lab performs a multi-step enzyme immunoassay test for influenza A or B antig... Read more
Reader Question:
Expect Denials for Year-Old Claims
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
You Be the Coder:
Know What's Bundled with Bladder Specimen
Question: I'm coding a pathology report that describes examination of a cystectomy specime... Read more
CCI 24.0:
Get On Board With Massive Edits For Your Lab
Keep claims-filing rules straight for bundled codes. CPT® 2018 brought you lots of new l... Read more
CCI Basics:
Master Bundling Edits With Resources and Documentation
Zero in on your payer's expectations. You already know that Medicare's Correct Coding Ini... Read more
Outpatient Billing:
Take Advantage of 14-Day Rule Change
Bill directly for molecular tests. If you bill for molecular or certain other tests, Jan.... Read more
Reader Question:
Capture Each Step for Urine Culture
Question: Our lab ran a urine culture for a nursing home patient with an indwelling cathet... Read more
Reader Question:
Get Used to ICD-10
Question: I often find myself coding ICD-9 in my head and then using a tool to "translate"... Read more
Reader Question:
'When' and 'Where' Can Sidetrack Appeals
Question: We're having trouble with our appeals and redetermi­nation requests, which seem... Read more
Reader Question:
Follow Payer Expectation for Multiple Test Modifier
Question: A clinician submitted four blood-gas samples taken throughout the day for a sing... Read more
You Be the Coder:
Grasp Details for Accurate Uterine Fibroid Coding
Question: Our pathologist received two very large fibroid specimens in a single container ... Read more
CPT® 2018:
Transform Bone Marrow Reporting With New, Revised Codes
Pay heed to new CCI instruction, too. When you report your pathologist's bone marrow case... Read more
ICD-10:
Sharpen Your HIV/AIDS Coding With this Quiz
Patient welfare and medical necessity are at stake. Maybe your lab is reporting results r... Read more
ICD-10 Coding Quiz:
Compare Your Answers to the Experts'
Don't give mistaken AIDS diagnosis. Making errors when reporting human immunodeficiency v... Read more
Reader Question:
Check Out Endometrial Hyperplasia Details
Question: I've been coding endometrial hyperplasia as N85.0, but a coder friend tells me t... Read more
Reader Question:
Use ABN Modifier for Non-Covered Flow Cytometry
Question: We recently had flow cytometry charges denied by Medicare for "diagnosis not med... Read more
Reader Question:
Don't Unbundle Alcian Blue/PAS
Question: What's the correct way to code an Alcian Blue/PAS stain to rule out Barrett's Es... Read more
Reader Question:
Forget Professional Component DOS Instruction
Question: I heard that Medicare issued a memo that we must bill the pathologist's professi... Read more
You Be the Coder:
Avoid Molecular Pathology Modifier Mix-Up
Question: We've recently started billing molecular pathology cases for pathologists. There... Read more
Clinical Lab:
Grasp Final CLFS Pricing Details for Your Lab
See exceptions to weighted-median valuation. Brace for payment reductions to about three ... Read more
CLFS:
Check Out New Code Pricing and More
Learn how ADLTs are different. The vast majority of codes paid on the Clinical Laboratory... Read more
CPT® 2018:
Greet New Way to Capture INR Monitoring
Change involves code additions and deletions. If your lab/pathologist is involved in anti... Read more
Documentation:
Master Clean Claims with Targeted Queries
Know when to ask for clarification. Sometimes you face a pathology report that seems to c... Read more
Reader Question:
Medical Necessity Can Trump CCI
Question: Our physician office lab performed rapid strep and rapid influenza tests that th... Read more
Reader Question:
Determine Reason for Lead Test
Question: A physician ordered a lead test as part of a pre-adoption examination for a 3-ye... Read more
You Be the Coder:
Choose Specific Colon Polyp Code
Question: We are trying to assign a diagnosis code for a specimen that the pathology repor... Read more
CPT® 2018:
Update New Category III Code Options for Your Lab
See how 0500T changes HPV coding, and more. An emerging technology for cadaver donor lung... Read more
CPT® 2018:
Explore 3 New Prostate Test Code Alternatives
MAAAs focus cancer risk assessment. Ever since the U.S. Preventive Services Task Force (U... Read more
Stem Cell Transplant:
Report Every Harvest Step to Capture Full Pay
Avoid bundling pitfalls that sabotage reimbursement. Billing for a pathologist with a hem... Read more
Reader Question:
Round Up Codes for This Pap Scenario
Question: We received a request for a Pap test six months following a prior Pap for the sa... Read more
Reader Question:
Identify Symptoms for Drug Screen Testing
Question: We're a physician office lab, and we had one of our doctors order a drug "screen... Read more
Reader Question:
Include All 80061 Components
Question: Our lab has a physician client who routinely orders total cholesterol and trigly... Read more
You Be the Coder:
Clarify Prostate 'Needle' Specimen
Question: I have a pathology report in which the "specimen" line states "prostate needle."... Read more
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