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Pathology/Lab Coding Alert

CPT® 2020:
Isolate New Codes for Microbiology Analyses
Don't miss relevant PLA additions. Microbiology labs have just one new Category I code fo... Read more
Category III Update:
Chemo-Screening Test Earns CPT® 2020 Code
Deleted 0357T leads to unlisted code. Among CPT® changes that lab coders might fail to n... Read more
Compliance:
Get Ready for Stricter Medicare Provider Enrollment Rules
New instruction may limit participation. Don't let “patients over paperwork” lull you... Read more
Reader Question:
Identify Esophageal Section
Question: What is the correct diagnosis code for a malignant lesion in the “abdominal es... Read more
Reader Question:
Use Encryption to Protect ePHI
Question: How can we make sure encryption is part of our HIPAA compliance? Codify Subscri... Read more
Reader Question:
Add Fecal Specimen to H. Pylori Test
Question: Can we bill the H. pylori detection and antibiotic resistance panel from America... Read more
Reader Question:
Choose 83500 for Activity
Question: We performed an antithrombin III activity assay for a patient taking heparin. Ho... Read more
Reader Question:
Find Breast History Without Final Dx
Question: The pathologist examines a lumpectomy specimen in which the op note states that ... Read more
You Be the Coder:
Capture Each Microbiology Step
Question: A physician performed incision and drainage of a subareolar breast abscess and s... Read more
CPT® 2020:
Don't Miss Therapeutic Drug Assay Update
Distinguish presumptive, definitive, therapeutic testing. You'll have six new codes to us... Read more
CPT® 2020:
Recognize PLA Drug Test Codes
You might need to pre-empt Category I. There's a catch for all the drug-test coding advic... Read more
Case Study:
Find Polyp Dx in Screening Colonoscopy
Focus procedure code, too. Specimens from colonoscopy procedures are common fare for path... Read more
QPP:
Look for MIPS Policy Changes for 2020
See what streamlined MVP may bring. With an update to the Quality Payment Program (QPP) o... Read more
Reader Question:
Specify Procedure and Reason for Aspergillus Test
Question: Our lab performed an EIA test for Aspergillus antigen detection, but we received... Read more
Reader Question:
Share Data With HIPAA Compliance
Question: I heard there's a new rule about sharing data under HIPAA. Is that true, and if ... Read more
You Be the Coder:
Distinguish Blood Draw Codes
Question: What is the difference in the venipuncture codes 36400-36410, 36420-36425, and 3... Read more
Clinical Lab:
Master PSA Test Claims in 4 Steps
Grasp code and compliance tips. If your lab runs plenty of prostate specific antigen (PSA... Read more
ICD-10-CM:
Fortify Diagnosis Coding With 3 Q/A Scenarios
Grasp your lab's contribution to final Dx. Whether your clinical lab receives a narrative... Read more
Medicare:
You're Not Immune to Fraud and Abuse Charges
Some coding practices could trap you. If you're holier-than-thou about healthcare provide... Read more
Reader Question:
Take These Tick-Bite Tips
Question: When a patient has a tick bite and the clinician orders a test for suspected Lym... Read more
Reader Question:
Distinguish Clinical Panel Test from Panel Code
Question: Our lab performs the obstetrics panel, but we use the automated treponemal antib... Read more
You Be the Coder:
Capture Each Bone Marrow Biopsy Step
Question: Our pathologist examined an iliac crest bone marrow biopsy following decalcifica... Read more
CPT® 2019 Lab Preview:
Look for New PLA, Molecular Pathology, and Chemistry Codes
Expect MAAA and microbiology changes, too. We have the scoop on new 2020 clinical laborat... Read more
ICD-10-CM:
Prepare for Lab-Relevant 2020 Diagnosis Codes
Start using new and revised codes Oct. 1, 2019. With 273 additions, 21 deletions, and 30 ... Read more
Medical Record:
Master Documentation Tips and Pitfalls
Use cut and paste judiciously. You may love the timesaving features of electronic health ... Read more
Reader Question:
Zero in on FNA Unit of Service
Question: How should I code the procedure when our pathologist extracts an FNA of lef... Read more
Reader Question:
Report Final Diagnosis
Question: Our pathologist received a biopsy of a single pulmonary nodule from the pat... Read more
You Be the Coder:
Focus Liver and Lymph Node Coding
Question: We have a case that the pathology report identifies as a “right hepatic w... Read more
Dermatopathology:
Discover Mohs Openings for Pathology Services
Steer clear of 17311-+17315. Mohs micrographic surgery might result in billable pathology... Read more
Coverage:
Master ABN Strategy With This 81551 Case
Beware LCD restrictions or lose pay. Sometimes the only card you hold to get paid for an ... Read more
HIPAA:
Play Taps for Phase 2 of the Audit Program
Don't expect more onsite visits. Three years after the kickoff of Phase 2 desktop audits,... Read more
Reader Question:
See What HIPAA Compliance Claims Really Promise
Question: Our office purchased encryption software that claims to be “100-percent HIPAA ... Read more
Reader Question:
Look for Password Relief
Question: Our IT consultant suggests that we update passwords every 30 days, but this is m... Read more
Reader Question:
Gather Testicle Specimen Info
Question: The pathologist performed an exam of a testicle removed for testicular torsion. ... Read more
You Be the Coder:
Check Out 'Lymphoma Workup' Rules
Question: I've heard that we can charge 88307 instead of 88305 when our pathologist evalua... Read more
Nucleic Acid Probes:
Tripped Up by Too Many ISH Codes? Read This
Distinguish anatomic and clinical tests. If you want to unscramble the four code families... Read more
Physician Service:
Focus ISH Professional Interpretation Billing
Distinguish TC, 26 modifier use. Now that you've read about the different code families f... Read more
PT/INR:
Check Out 2 Coumadin Coverage Rules
Don't miss management pay. With the need to oversee coagulation in approximately 20 milli... Read more
Audit Proof:
7 Tips Safeguard Your MIPS Data
Secure documentation for six years. If you're involved in Merit-Based Incentive Payment S... Read more
Reader Question:
Identify Lipoma for Code Selection
Question: The op note states that the surgeon performed a herniorrhaphy and that the submi... Read more
Reader Question:
Go to Drug Screen Codes
Question: When our lab tests a blood specimen for several possible drugs of abuse such as ... Read more
You Be the Coder:
Check Out Twin Placenta Scenario
Question: If we receive a twin placenta in two separate containers can we charge 88307 x 2... Read more
Anatomic Pathology:
4 Steps Spotlight Whipple-Case Coding
Don't miss bundling restrictions. When your pathologist evaluates a surgical Whipple rese... Read more
Molecular Studies:
Q&A Strengthens Genetic-Testing Know How
Look for coverage opportunities. More and more labs are offering genetic tests to aid phy... Read more
ICD-10-CM Basics:
Decipher Excludes1 Notes For Correct Dx Coding
Let the latest Coding Clinic provide direction. When you spy the Excludes1 note under an ... Read more
Reader Question:
Choose ICD-10 From Pathology Final Dx
Question: Our pathologist received a bladder specimen described in the op report as “an ... Read more
Reader Question:
Get Your CMS Info in Podcast Form
Question: I heard CMS now has a podcast to update policy information. Is that true, and if... Read more
You Be the Coder:
Select Best Glucose Tolerance Test Code(s)
Question: How should we bill a glucose 2 hour test — we tested the patient's fasting glu... Read more
Prostate Biopsy:
Capture Accurate IHC-Stain Pay for G0416 Cases
88344 is still ‘per specimen.' You have only one code choice for Medicare beneficiary p... Read more
Medicare Policy:
Review Your AP-Pro-Fee DOS Practices
Specimen-collection date may be wrong. When you bill the professional component of anatom... Read more
OIG Report:
Ramp Up for CMS's Audit Focus
Emphasize 4 areas to beat the odds. The HHS Office of Inspector General (OIG) recently pu... Read more
Reader Questions:
Grasp Reasons for 88141
Question: What type of diagnosis is acceptable to bill a pathologist's review of an a... Read more
Reader Questions:
More on 87804
Question: You stated in last month's newsletter that the lab should not report two un... Read more
Reader Questions:
Make Sure Pay-Back is Timely
Question: Our lab performed an internal audit and determined that we have received so... Read more
You Be the Coder:
Manage Vitamin D Coding
Question: The lab receives an order for serum levels of vitamin D2 and D3. What are the co... Read more
Influenza 2019:
Master Lab Codes for Flu Tests With These 3 Tips
Don't miss separate codes for types. Flu season isn't over and may be peaking late, accor... Read more
Case Study:
Focus GI Specimen and Diagnosis Codes
Skip reporting pre-op diagnosis. When your pathologist examines and diagnoses multiple GI... Read more
ACOs:
Prepare Your Lab for MSSP Rule Changes
Balance risk/reward for savings payoff. If your lab is part of an Accountable Care Organi... Read more
Reader Question:
Bundle Tubes With Uterus
Question: Our pathologists are receiving more routine hysterectomies with bilateral fallop... Read more
Reader Question:
Use Appropriate ABN Modifier
Question: We have an ABN notice for a patient's Pap test because the physician ordere... Read more
Reader Question:
Understand LCD/ICD-10 Connection
Question: I heard that Medicare is changing LCDs to eliminate ICD-10 codes. Does that mean... Read more
Reader Question:
Pinpoint Vaginal Smear Procedure
Question: A clinician submitted a vaginal smear for a patient experiencing discharge ... Read more
You Be the Coder:
Assign Pathology Final Diagnosis
Question: Our pathologist examined a skin lesion of the patient's right ear submitted... Read more
CCI Update:
Don't Let New Lab Bundles Compromise Your Pay
CPT® 2019 codes top restriction list. The massive Correct Coding Initiative (CCI) versio... Read more
CPT® 2019:
Broaden HCV Patient Testing With 81596
Grasp guidelines for new liver-disease MAAA code. Your lab's hepatitis C virus (HCV) test... Read more
Compliance:
Assimilate New HHS Cybersecurity Guidance
Streamline methods for your lab's needs. Electronic health records (EHR) and other inform... Read more
Reader Question:
Capture CF Procreative Testing
Question:  Our lab performs testing for genetic carrier status for cystic fibrosis in... Read more
Reader Question:
Detail Genes for Colon Cancer Test
Question: Our lab performed a Buccal Colaris genetic test for a patient based on a family ... Read more
You Be the Coder:
Master Intraoperative Frozens and Touch-Prep Coding
Question: Our pathologist evaluated a colon resection during surgery by performing frozen ... Read more
2019 Medicare Pay:
Grasp Final Rule Impact for Your Lab
Don't miss change to PAMA implementation. Your pathology practice or clinical lab can exp... Read more
CPT® 2019:
Update BRCA1, BRCA2 Test Codes
Make sure you change from the ‘old way' to the ‘new way,' or lose pay. If your lab pe... Read more
Protect PHI:
Put 3 Skills in Your HIPAA-Compliance Toolbox
Foil insider breach threats. You may be ready for ransomware takedowns and other outside ... Read more
Reader Question:
Learn sdLDL Clinical Value
Question:  What is the purpose of the new lab test for small dense LDL cholesterol? ... Read more
Reader Question:
Focus Hemorrhoidectomy Coding
Question: Our pathologist examined a second-degree hemorrhoidectomy specimen excised due t... Read more
You Be the Coder:
Grab Sentinel Node Pay
Question: We received a 3.2 cm scalp lesion excision, which the pathologist diagnosed as c... Read more
FOBT:
Q/A Scenarios Focus Coding for Colorectal Cancer Screening
Lab test method, purpose, drive code choice. With a growing number of lab tests that phys... Read more
Molecular Tests:
More Q/A Scenarios Clarify CRC Genetic Test Options
Learn the genes associated with colon cancer. Although fecal occult blood test (FOBT) lab... Read more
HIPAA Compliance:
Take Heed of State Privacy-Law Enforcement
OCR isn't the only watchdog now. Your lab can't afford to get complacent about HIPAA viol... Read more
Reader Question:
Pinpoint CCI Edit Differences
Question: Could you please explain the difference between Medically Unlikely Edits and Mut... Read more
Reader Question:
Exactly Match Panel-Code Test List
Question: Our lab received an order for blood electrolytes potassium, sodium, total calciu... Read more
Reader Question:
Laser-Focus MAAA Codes for Proprietary Test
Question: Our lab performs a non-invasive prenatal test for trisomy 18 and 21 called Visib... Read more
You Be the Coder:
Find Most Specific Genetic Test Code
Question: I see that CPT® 2019 adds a new code for genetic testing for severe inherited c... Read more
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