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Pathology/Lab Coding Alert

CPT® 2021:
Master Microbiology Updates Including More SARS-CoV-2 Codes
Drop ‘multiple step' distinction for code selection. Before the ink was dry on the CPT�... Read more
Compliance:
Check Out COVID-19 Exceptions That Impact Your Lab
Monitor PHE-related regulations. As COVID-19 cases are ramping up in many locations, coi... Read more
Practice Management:
Know Your Medicare AAP Recoupment Relief Options
Look for help with pandemic-related financial hardship. As the pandemic swirls up money w... Read more
You Be the Coder:
Clarify Breast/Lymph Bundles
Question: Our pathologist received tissue from a breast case in two separate containers �... Read more
Reader Questions:
Determine Fluid Specimen Source
Question: Our pathologist evaluated a fluid specimen from an ovarian cyst submitted by an ... Read more
Reader Questions:
Avoid This ‘Uncertain’ Dx Trap
Question: The pathology report for a urinary bladder specimen simply states “neoplasm”... Read more
Reader Questions:
Bill for Completed Tissue Exam
Question: The surgeon sent five, separately identified colon polyp specimens from a colon... Read more
COVID-19:
Round Out SARS-CoV-2 Antibody Coding Options
Don't miss new quantitative test. With the latest CPT® code for SARS-CoV-2 antibody test... Read more
Clip and Save:
Summarize SARS-CoV-2 Tests
With the fast and furious release of new CPT® codes for SARS-CoV-2 testing, it pays to ta... Read more
FNA Extraction:
Follow NCCI Bundling Rules for FNA Cases
Beware pathologist's dual role. When your pathologist performs both the fine needle aspir... Read more
Compliance:
Check Out ABN Changes That Impact Your Lab
Don't let January 1 deadline sneak up on you. If you took the “free pass” and didn't... Read more
Reader Questions:
Keep NPI Across State Lines
Question: Our pathology practice is moving from Louisiana to Texas. Do our pathologists ne... Read more
Reader Questions:
Contact COVID-19 Patients for Plasma Donation
Question: We have physician clients ordering follow-up testing for patients who have ... Read more
ICD-10-CM 2021:
Prep for Lab- and Pathology-Relevant Diagnosis Codes
Kick off new diagnoses starting Oct. 1. Your lab needs to review the broad sweep of ICD-1... Read more
2021 ICD-10-CM:
Master Diagnosis Coding With Guideline Changes and More
COVID-19 instruction leads the way. Code additions, revisions, and deletions aren't the o... Read more
Modifier 59:
Ramp Up X{EPSU} Use for Specific Lab Scenarios
Note NCCI Policy Manual updates. Maybe your pathology practice has received a payer notic... Read more
Reader Questions:
Code Convalescent Plasma Infusion for COVID-19 Patient
Question: We have a hematopathologist who is performing convalescent plasma infusion for C... Read more
Reader Questions:
‘Therapeutic’ is Key to Phlebotomy Code
Question: Our hematopathologist performed a therapeutic phlebotomy in the office for a pat... Read more
You Be the Coder:
Zero in On G0452 Requirements
Question: When we have a request for interpretation on a molecular pathology test in ... Read more
CPT® 2021 Lab Preview:
Peek at New Codes Unveiled by CLFS Annual Meeting
Look for additions to drug, molecular tests, and more. New clinical laboratory test codes... Read more
New SARS-CoV-2 Test:
Add 87426 to COVID-19 Diagnosis Arsenal
Greet infectious agent antigen detection option. With myriad nucleic acid tests available... Read more
Part B Pay:
Ace Pathology Billing With MPFS Database Tools
Thread the PC/TC needle for different services. If you've ever had problems billing your ... Read more
You Be the Coder:
Count Blocks and Stains for 88312
Question: The pathology report describes a partial lung resection processed as six blocks ... Read more
Reader Questions:
Follow Lymph Node Bundling Rules
Question: Our pathologist examined a spleen specimen with attached splenic nodes. I notice... Read more
Reader Questions:
CMS Restarting Medical Review
Question: I've heard that CMS is suspending medical reviews for the duration of the COVID-... Read more
HCPCS Level II:
Don't Lose $49 per SARS-CoV-2 Test
 Distinguish high-throughput codes. Many labs have ramped up testing for SARS-CoV-2,... Read more
Case Study:
Seize Burn-Case Facts for Accurate Coding
Don't miss double duty for biopsy specimen. Patients with serious burns may require a ran... Read more
HIPAA:
Grasp COVID-19-Inspired OCR Privacy Reminder
Keep in mind ‘prior authorization.' With the flood of information about new pandemic he... Read more
Reader Questions:
Look Out for Modifier CR Use
Question: I've heard we are supposed to be using modifier CR on COVID-19 related claims. C... Read more
Reader Questions:
Don't Miss Lymph Node Pay with Nephrectomy
Question: Our pathologist received a partial nephrectomy specimen and a separate container... Read more
Reader Questions:
Publicize SARS-CoV-2 Test Price
Question: Our lab doesn't typically post the cash price for tests on our website, but I've... Read more
You Be the Coder:
Match FNA 'Pass' to 'Evaluation Episode'
Question: The pathologist documented evaluating two “passes” from a thyroid FNA for sp... Read more
COVID-19:
Know Your Specimen Collection Billing Options
Master ‘G' codes for independent labs. With varied sites and personnel for COVID-19 lab... Read more
New PLA Code:
Greet 0202U for Respiratory Panel That Includes SARS-Cov-2
Mesh use with existing test codes. In an off-cycle move, the AMA issued a new Proprietary... Read more
Breast Case:
Steer Breast-Lump Code Choice With Path Report Details
Missed specimen identification could cost you $210. Coding for your pathologist's breast ... Read more
Reader Questions:
Let QW Save Your COVID-19 Test Claims
Question: We are a physician office lab and are performing some COVID-19 rapid lab tests, ... Read more
Reader Questions:
Welcome High-Throughput SARS-CoV-2 Test Codes
Question: I've heard there are new codes for SARS-CoV-2 lab tests using high-throughput in... Read more
Reader Questions:
Check Payer for HPV Coding Direction
Question: Our lab performed an HPV test for a 40-year-old patient who has not had a gyneco... Read more
You Be the Coder:
Focus Ovary Procedure and Dx Codes
Question: Our pathologist received a right salpingo-oophorectomy specimen and identifies a... Read more
Serological Testing:
Update SARS-CoV-2 Code Options for Antibody Tests
Master CPT® April 10 revisions. Whether your lab uses a laboratory-developed test or a c... Read more
Case Study:
Miss Dx or Payer and Lose Pap Test Pay
See how method impacts code choice. When your lab gets a Pap test order, you need to an... Read more
ICD-10-CM:
Ace COVID-19 Dx Coding with 4 Tips
See how code order counts. Although your lab won't assign an ICD-10 code based on test ... Read more
Reader Question:
Don't Miss 2-Code Urine Culture Problem
Question: Our lab received two urine specimen tubes for complete urinalysis with reflex to... Read more
You Be the Coder:
Account for Multiple Respiratory Virus Tests
Question: Our lab often gets orders for both SARS-CoV-2 testing and testing for Influenza ... Read more
COVID 19:
Greet New Diagnosis and Lab Test Codes
Monitor developments for your lab. With COVID-19 pandemic information changing daily, use... Read more
Toolkit:
Follow COVID-19 Developments
Learn key resources to stay up to date. With information related to the COVID-19 pandemic... Read more
CERT Report:
Highlight Laboratory Documentation Deficiency
Improve quality for ‘sufficient' records. Your lab undoubtedly strives for excellent do... Read more
Reader Question:
Know When to Use 'Repeat' Modifier
Question: The lab performed four CK level tests for an ER patient within a 24-hour period,... Read more
Reader Question:
You Won't Miss Modifier GD
Question: I see that HCPCS 2020 deletes modifier GD. Does this impact coding for multiple ... Read more
Reader Question:
Identify PSA Test Options
Question: Our lab performed repeat PSA tests for a patient who had a radical prostatectomy... Read more
Reader Question:
Learn Medicare Appeals Levels
Question: My Medicare MAC denied a claim I submitted, and I want to appeal the decision. W... Read more
You Be the Coder:
Distinguish LEEP Specimens
Question: Our pathologist received a cervical LEEP specimen from a colposcopy with a loop ... Read more
Anatomic Pathology:
Challenge Dx and Procedure Coding Skills With This Uterine Case
Master hyperplasia terminology. Pathology cases involving uterine endometrium can hold ma... Read more
Novel Coronavirus:
Prepare for COVID-19 Impact at Your Lab
Know when to engage public health. Even if your lab doesn't currently test for COVID-19... Read more
Compliance:
Master HIPAA Breach Notification Rules
Preparation lowers risk and penalties. If your lab faces a breach of patient protected ... Read more
Reader Question:
Don't Double-Dip Mohs Pathology
Question: We have a dermatology clinic client who sometimes sends our pathologist slides f... Read more
Reader Question:
Behavior Drives Tumor Dx
Question: The pathologist diagnosed a specimen as a pineocytoma. Which ICD-10 code should ... Read more
You Be the Coder:
Distinguish FISH Codes for HER2/neu
Question: We have a pathology report for a breast biopsy exam, and the report states, “T... Read more
Case Study:
Sidestep Referred-Material Consultation Pitfalls
Beware unit of service impact. When your pathologist consults on material referred from a... Read more
NCDs:
Integrate Diagnosis Changes into Your Coverage Rules
Avoid using truncated codes. Dragging your feet to incorporate the latest ICD-10-CM codes... Read more
Clinical Lab:
Capture Celiac Disease Test Sequence
Focus molecular HLA typing. Testing protocols for celiac disease diagnosis can be a compl... Read more
Reader Question:
Master Stromal Tumor Diagnosis Coding
Question: The pathologist examined an esophageal biopsy from an esophagogastroduodenoscopy... Read more
Reader Question:
Change Documentation With Care
Question: When we see that documentation doesn't match a code choice, we usually go back t... Read more
Reader Question:
Code Reason for Hepatitis C Screen
Question: Our lab performs a hepatitis C screening for a Medicare patient with an injectio... Read more
You Be the Coder:
Learn G0455 FMT Restriction
Question: Our pathologist works with a gastroenterologist at our hospital for fecal microb... Read more
CPT® 2020:
Master Molecular Pathology Code Updates
Don't miss Tier 2 to Tier 1 conversions. If your lab performs gene analyses, you need to ... Read more
FNA:
Capture Each Step of Aspirate Biopsy Case
But beware bundled services. When your pathologist evaluates a fine needle aspiration (FN... Read more
Compliance:
Focus You Lab's HIPAA Policies for 2020
Train, monitor, modify to keep procedures current. Strengthening your HIPAA compliance to... Read more
Reader Question:
Search for 'Payable Diagnoses'
Question: We've always turned to our Medicare contractor's LCDs to find a list of pay... Read more
You Be the Coder:
Find Diagnosis, Procedure Codes for Drug Screen
Question: A clinician orders a drug test screen for a patient presenting with constricted ... Read more
CPT® 2020:
Take on 3 New Category I MAAA Codes
Distinguish codes for similar tests. When January 1 rolls around, you'll need to know abo... Read more
2020 Medicare Pay:
Learn MPFS Final Rule Impact for Your Pathology Lab
Pap interpretation takes big hit. Changes are coming down the pike for payment on some hi... Read more
Compliance:
Embrace Stark Law Changes
Value-based care is driving the revisions. If your pathology practice has stumbled over S... Read more
Reader Question:
Focus 'Medical Necessity' for Billing
Question: Sometimes we get denials for a procedure our pathologist performed due to lack o... Read more
Reader Question:
Capture Repeat Sodium Test Pay
Question: Our lab performed a basic metabolic panel (total calcium), followed by two sodiu... Read more
You Be the Coder:
Parse TB Test Coding
Question: Our lab received an order for an IGRA test for TB for a 30-year-old patient who ... Read more
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