Pathology/Lab Coding Alert
CPT® 2023:
Make Room for RNA Cancer Panel Coding
See how new codes impact pay. Targeted genomic sequence panels for solid organ or blood/l... Read more
Make Room for RNA Cancer Panel Coding
See how new codes impact pay. Targeted genomic sequence panels for solid organ or blood/l... Read more
Clinical Lab:
Update Your PLA Coding With CPT® 2023 Additions
Examine a wide range of new oncology tests. If you don't keep up with the AMA quarterly u... Read more
Update Your PLA Coding With CPT® 2023 Additions
Examine a wide range of new oncology tests. If you don't keep up with the AMA quarterly u... Read more
No Surprises Act:
Check Out the Latest NSA Final Rule Impact for Your Lab
Don't miss the effect of court decisions. The Feds are modifying the No Surprises Act (NS... Read more
Check Out the Latest NSA Final Rule Impact for Your Lab
Don't miss the effect of court decisions. The Feds are modifying the No Surprises Act (NS... Read more
Reader Question:
Go Soft on This Neoplasm Code
Question: What is the correct code for leiomyosarcoma of the sigmoid colon? I have fo... Read more
Go Soft on This Neoplasm Code
Question: What is the correct code for leiomyosarcoma of the sigmoid colon? I have fo... Read more
Reader Question:
Report Final Pathology Diagnosis
Question: The surgeon submitted a stomach biopsy of “inflamed tissue” from an eso... Read more
Report Final Pathology Diagnosis
Question: The surgeon submitted a stomach biopsy of “inflamed tissue” from an eso... Read more
Reader Question:
Respect HIPAA for Faxed Results
Question: Sometimes a client or patient requests faxed lab test results. What are the... Read more
Respect HIPAA for Faxed Results
Question: Sometimes a client or patient requests faxed lab test results. What are the... Read more
Reader Question:
Query 2 Bilirubin Tests
Question: The lab performs a total bilirubin and direct bilirubin test. Can we report... Read more
Query 2 Bilirubin Tests
Question: The lab performs a total bilirubin and direct bilirubin test. Can we report... Read more
You Be the Coder:
Distinguish IHS Procedures
Question: The pathologist evaluated a breast biopsy specimen and used immunohistochem... Read more
Distinguish IHS Procedures
Question: The pathologist evaluated a breast biopsy specimen and used immunohistochem... Read more
Microbiology:
Get Ready to Report New CPT® 2023 Microorganism Codes
Some relevant PLA codes are already effective. In just two short months, you'll be using ... Read more
Get Ready to Report New CPT® 2023 Microorganism Codes
Some relevant PLA codes are already effective. In just two short months, you'll be using ... Read more
ICD-10-CM:
Grasp 4 Tips to Master Dx Code Sequencing
These pathology examples will help you follow guidelines and code-level instruction. Gett... Read more
Grasp 4 Tips to Master Dx Code Sequencing
These pathology examples will help you follow guidelines and code-level instruction. Gett... Read more
Compliance:
Follow This Advice for Clean Medicare Claims
See how billing error codes can guide you. You know it's wise to learn from your mistak... Read more
Follow This Advice for Clean Medicare Claims
See how billing error codes can guide you. You know it's wise to learn from your mistak... Read more
Reader Questions:
Hone Your Influenza Test Coding
Question: I work in a CLIA-waived lab, and we use an influenza test kit that provides a vi... Read more
Hone Your Influenza Test Coding
Question: I work in a CLIA-waived lab, and we use an influenza test kit that provides a vi... Read more
Reader Questions:
Focus on DOS Rules
Question: We received a saliva specimen for a genetic screening test that had been stored ... Read more
Focus on DOS Rules
Question: We received a saliva specimen for a genetic screening test that had been stored ... Read more
You Be the Coder:
Solve Sentinel Node Conundrum
Question: Our pathologist received two containers, one marked “skin lesion, right upper ... Read more
Solve Sentinel Node Conundrum
Question: Our pathologist received two containers, one marked “skin lesion, right upper ... Read more
CPT® 2023:
Look for New Category III Slide Digitization Codes
Prepare for 13 specific add-on codes. When your pathology practice digitizes glass micros... Read more
Look for New Category III Slide Digitization Codes
Prepare for 13 specific add-on codes. When your pathology practice digitizes glass micros... Read more
Clinical Lab:
Get Ready for Monkeypox Testing and Reporting
87593 captures orthopoxvirus assay. After years of focus on SARS-CoV-2, there's a new vir... Read more
Get Ready for Monkeypox Testing and Reporting
87593 captures orthopoxvirus assay. After years of focus on SARS-CoV-2, there's a new vir... Read more
Technology Corner:
See How Shared Drive Can Securely Aid Remote Work
Stay HIPAA compliant wherever your staff toils. Remote and hybrid work that ramped up du... Read more
See How Shared Drive Can Securely Aid Remote Work
Stay HIPAA compliant wherever your staff toils. Remote and hybrid work that ramped up du... Read more
Reader Questions:
See If Margins Earn Separate Code
Question: Our pathologist diagnosed an enterectomy “specimen A” as adenocarcinoma... Read more
See If Margins Earn Separate Code
Question: Our pathologist diagnosed an enterectomy “specimen A” as adenocarcinoma... Read more
Reader Questions:
Code This Cytospin Case
Question: The lab received a CSF specimen and performed a cytospin. The lab then smea... Read more
Code This Cytospin Case
Question: The lab received a CSF specimen and performed a cytospin. The lab then smea... Read more
Reader Questions:
Expect Ongoing Medical Records Review
Question: We'd heard that medical records reviews were on hold due to the COVID-19 PH... Read more
Expect Ongoing Medical Records Review
Question: We'd heard that medical records reviews were on hold due to the COVID-19 PH... Read more
You Be the Coder:
Check Organism and Dx Details for GI Pathogen Pay
Question: I'm getting denials for 87507 when we run a multiplex nucleic acid panel fo... Read more
Check Organism and Dx Details for GI Pathogen Pay
Question: I'm getting denials for 87507 when we run a multiplex nucleic acid panel fo... Read more
Preview CPT® Lab Codes:
Jumpstart Your 2023 Readiness With This CLFS Annual Meeting Rundown
Prep for new, specific microbiology codes. You can never start too early to learn about w... Read more
Jumpstart Your 2023 Readiness With This CLFS Annual Meeting Rundown
Prep for new, specific microbiology codes. You can never start too early to learn about w... Read more
Surgical Pathology:
Focus Your ‘Toenail’ Procedure Coding With These Details
Secure ancillary pay for additional studies. Although “toenail” is an unlisted spec... Read more
Focus Your ‘Toenail’ Procedure Coding With These Details
Secure ancillary pay for additional studies. Although “toenail” is an unlisted spec... Read more
MPFS Proposed Rule:
See How Conversion Factor Decrease Could Affect Your Lab in 2023
You still have time to comment. Between never-ending COVID cases and rising inflation, st... Read more
See How Conversion Factor Decrease Could Affect Your Lab in 2023
You still have time to comment. Between never-ending COVID cases and rising inflation, st... Read more
Reader Questions:
Target Your 87913 Use
Question: I heard that 87913 is a new code for COVID-19 testing. Is that true, and if... Read more
Target Your 87913 Use
Question: I heard that 87913 is a new code for COVID-19 testing. Is that true, and if... Read more
Reader Questions:
Don’t Trash HIPAA With Records Disposal Methods
Question: Are there specific rules regarding records disposal under HIPAA? Kansas Su... Read more
Don’t Trash HIPAA With Records Disposal Methods
Question: Are there specific rules regarding records disposal under HIPAA? Kansas Su... Read more
Reader Questions:
Beware ‘Consistent With’ for Dx Coding
Question: We received a pathology report for an excised “mass” from the patient'... Read more
Beware ‘Consistent With’ for Dx Coding
Question: We received a pathology report for an excised “mass” from the patient'... Read more
You Be the Coder:
Clarify Specimens to Capture Bone-Marrow Specimen Pay
Question: When the pathologist gets bone marrow specimens from a surgical procedure, ... Read more
Clarify Specimens to Capture Bone-Marrow Specimen Pay
Question: When the pathologist gets bone marrow specimens from a surgical procedure, ... Read more
ICD-10-CM:
Preview Lab-Relevant Dx Code Changes Coming Oct. 1
Payment may depend on codes that show medical necessity. With more than 1,500 new and rev... Read more
Preview Lab-Relevant Dx Code Changes Coming Oct. 1
Payment may depend on codes that show medical necessity. With more than 1,500 new and rev... Read more
Table:
Clip and Save Endometriosis Dx
This table provides a breakdown of the new ICD-10-CM 2023 endometriosis codes that go in e... Read more
Clip and Save Endometriosis Dx
This table provides a breakdown of the new ICD-10-CM 2023 endometriosis codes that go in e... Read more
Case Study:
Pick Up CISH Pay in Tongue Biopsy Case
See if dx could impact exam code selection. When you're reporting a pathology tissue exa... Read more
Pick Up CISH Pay in Tongue Biopsy Case
See if dx could impact exam code selection. When you're reporting a pathology tissue exa... Read more
Compliance:
COVID-19 Testing Data Puts Labs in OIG Spotlight
Watch for future scrutiny of test frequency and utilization. Through audit and enforcem... Read more
COVID-19 Testing Data Puts Labs in OIG Spotlight
Watch for future scrutiny of test frequency and utilization. Through audit and enforcem... Read more
Reader Questions:
Master Multiple Organism Coding
Question: The lab evaluates a swab from a skin lesion for Staphylococcus aureus, Stre... Read more
Master Multiple Organism Coding
Question: The lab evaluates a swab from a skin lesion for Staphylococcus aureus, Stre... Read more
Reader Questions:
Grab These HIPAA Helpers
Question: We've been experiencing an increase in phishing and are aware of reports o... Read more
Grab These HIPAA Helpers
Question: We've been experiencing an increase in phishing and are aware of reports o... Read more
You Be the Coder:
Focus FNA Specimen Coding
Question: Our lab has a physician client who performs a lot of FNA procedures. Sometimes o... Read more
Focus FNA Specimen Coding
Question: Our lab has a physician client who performs a lot of FNA procedures. Sometimes o... Read more
Breast Case:
Hone Your Procedure and Dx Coding Skills With This Implant Situation
Unit of service can trip you up. Sometimes unusual pathology cases make the best learning... Read more
Hone Your Procedure and Dx Coding Skills With This Implant Situation
Unit of service can trip you up. Sometimes unusual pathology cases make the best learning... Read more
Clinical Lab:
Avoid 3 CBC Coding Pitfalls That Hamper Your Claims
Pick the correct modifier for repeat tests. You can hardly watch a medical TV show or sp... Read more
Avoid 3 CBC Coding Pitfalls That Hamper Your Claims
Pick the correct modifier for repeat tests. You can hardly watch a medical TV show or sp... Read more
Privacy Rule:
Watch Out for State Laws That Supersede HIPAA
Compliance depends on state regulation review. Plenty of states have laws that regulate p... Read more
Watch Out for State Laws That Supersede HIPAA
Compliance depends on state regulation review. Plenty of states have laws that regulate p... Read more
Reader Questions:
Surgeon May Have Final Say in Dx Coding
Question: The pathologist examined an esophageal biopsy taken during an esophagogastr... Read more
Surgeon May Have Final Say in Dx Coding
Question: The pathologist examined an esophageal biopsy taken during an esophagogastr... Read more
Reader Questions:
Tier 1 Molecular Pathology: # Resequenced Is Trending
Question: When I'm trying to find a tier 1 molecular pathology test code in the CPT®... Read more
Tier 1 Molecular Pathology: # Resequenced Is Trending
Question: When I'm trying to find a tier 1 molecular pathology test code in the CPT®... Read more
You Be the Coder:
Don’t Miss 2 Codes for 2 Antibody Classes
Question: Our lab received an order for IgG and IgM antibody testing for toxoplasmosi... Read more
Don’t Miss 2 Codes for 2 Antibody Classes
Question: Our lab received an order for IgG and IgM antibody testing for toxoplasmosi... Read more
CPT® 2022:
Sort Out Options for Constitutional Disorder Testing
Don't miss new code for low-pass sequencing analysis. Lots of small changes come together... Read more
Sort Out Options for Constitutional Disorder Testing
Don't miss new code for low-pass sequencing analysis. Lots of small changes come together... Read more
Compliance:
Indicate Your Part of a Lab Service With Crucial Modifiers TC and 26
Break down global codes for correct payment. Sometimes labs should use modifier 26 (Prof... Read more
Indicate Your Part of a Lab Service With Crucial Modifiers TC and 26
Break down global codes for correct payment. Sometimes labs should use modifier 26 (Prof... Read more
Telehealth:
Look for Some Telehealth Relief Beyond the PHE
Legislation gives limited waiver extension. With many providers angling to make COVID-19 ... Read more
Look for Some Telehealth Relief Beyond the PHE
Legislation gives limited waiver extension. With many providers angling to make COVID-19 ... Read more
Reader Questions:
Honor Certain PHI Restriction
Question: Are we required to honor a patient's request to limit or restrict disclosur... Read more
Honor Certain PHI Restriction
Question: Are we required to honor a patient's request to limit or restrict disclosur... Read more
Reader Questions:
Code CBC Without Platelets
Question: The ordering physician requested a CBC without platelets but with a differe... Read more
Code CBC Without Platelets
Question: The ordering physician requested a CBC without platelets but with a differe... Read more
Reader Questions:
Keep Compliant With HIPAA Risk Analysis
Question: Can we switch to gap analysis of how we implement HIPAA compliance instead ... Read more
Keep Compliant With HIPAA Risk Analysis
Question: Can we switch to gap analysis of how we implement HIPAA compliance instead ... Read more
You Be the Coder:
Reason for Oophorectomy Leads Code Choice
Question: The pathologist examined a bilateral oophorectomy specimen from a patient w... Read more
Reason for Oophorectomy Leads Code Choice
Question: The pathologist examined a bilateral oophorectomy specimen from a patient w... Read more
Prostate Case:
Follow Medicare Rules for Biopsy Exam — Even If You Don’t Like the Pay
Find out when to switch from screening to diagnostic PSA codes. When you bill a prostate ... Read more
Follow Medicare Rules for Biopsy Exam — Even If You Don’t Like the Pay
Find out when to switch from screening to diagnostic PSA codes. When you bill a prostate ... Read more
Compliance:
Improve Lab Claims’ Success With Proper Modifiers
Find out if your lab can use modifier 90. Whether you're dealing with claims for clinical... Read more
Improve Lab Claims’ Success With Proper Modifiers
Find out if your lab can use modifier 90. Whether you're dealing with claims for clinical... Read more
HIPAA:
Banner Breach Year Means You Should Up Your Cybersecurity Game
Federal tools can help — just in time. You should be focused on reducing data risks f... Read more
Banner Breach Year Means You Should Up Your Cybersecurity Game
Federal tools can help — just in time. You should be focused on reducing data risks f... Read more
Reader Questions:
Use Patient Location for POS
Question: We've been getting denials for COVID-19 test claims with the statement “The pr... Read more
Use Patient Location for POS
Question: We've been getting denials for COVID-19 test claims with the statement “The pr... Read more
Reader Questions:
Hit Bull’s-Eye for PLA Targets
Question: Our lab has been using the Cepheid Xpert® Xpress test using the GeneXpert Infin... Read more
Hit Bull’s-Eye for PLA Targets
Question: Our lab has been using the Cepheid Xpert® Xpress test using the GeneXpert Infin... Read more
You Be the Coder:
See How to Count Time for Pathology Consultation
Question: I'm trying to use the new clinical pathology consultation codes. Could you expla... Read more
See How to Count Time for Pathology Consultation
Question: I'm trying to use the new clinical pathology consultation codes. Could you expla... Read more
Compliance:
Use Appropriate Q2 PLA Code to Avoid Denials
April 1 is the first day of the second quarter when these codes go into effect. Quarterly... Read more
Use Appropriate Q2 PLA Code to Avoid Denials
April 1 is the first day of the second quarter when these codes go into effect. Quarterly... Read more
ICD-10:
Scrap These Uterine Hyperplasia Dx Errors That Could Cost You $150
Discover EIN diagnosis impact on procedure coding. Accurate diagnosis coding isn't an e... Read more
Scrap These Uterine Hyperplasia Dx Errors That Could Cost You $150
Discover EIN diagnosis impact on procedure coding. Accurate diagnosis coding isn't an e... Read more
HIPAA:
Tighten Your ‘Right of Access’ Compliance or Face Enforcement Action
Assume the rules don't apply to labs at your peril. Take a hint: six out of seven Biden ... Read more
Tighten Your ‘Right of Access’ Compliance or Face Enforcement Action
Assume the rules don't apply to labs at your peril. Take a hint: six out of seven Biden ... Read more
Reader Questions:
Don’t ‘Approximate’ Panel Test Codes
Question: A clinician requested a “panel” of tests to aid in the diagnosis of gro... Read more
Don’t ‘Approximate’ Panel Test Codes
Question: A clinician requested a “panel” of tests to aid in the diagnosis of gro... Read more
Reader Questions:
Payer Leads Pap Interpretation Code Choice
Question: What's the difference between G0141 and 88141, and when should we use one ... Read more
Payer Leads Pap Interpretation Code Choice
Question: What's the difference between G0141 and 88141, and when should we use one ... Read more
Reader Questions:
Revise Bilateral Ovarian Cancer Dx
Question: Our pathologist examined a bilateral oophorectomy specimen and diagnosed ep... Read more
Revise Bilateral Ovarian Cancer Dx
Question: Our pathologist examined a bilateral oophorectomy specimen and diagnosed ep... Read more
You Be the Coder:
Bundle Sinuplasty Bits and Pieces
Question: The pathologist examined the contents of a container submitted from an endo... Read more
Bundle Sinuplasty Bits and Pieces
Question: The pathologist examined the contents of a container submitted from an endo... Read more
CPT® 2022:
Ditch ‘Unlisted’ Codes to Get Correct Chemistry Test Pay
Update therapeutic drug assay coding for RA patients. With four additional CPT® 2022 cod... Read more
Ditch ‘Unlisted’ Codes to Get Correct Chemistry Test Pay
Update therapeutic drug assay coding for RA patients. With four additional CPT® 2022 cod... Read more
Ancillary Service:
Take 4 Steps to Master Special Stain Coding for Accurate Claims
Overlooked unit-of-service equals squandered pay. Special stains are common ancillary s... Read more
Take 4 Steps to Master Special Stain Coding for Accurate Claims
Overlooked unit-of-service equals squandered pay. Special stains are common ancillary s... Read more
Federal Regulation:
See How MPFS Final Rule and Congressional Action Impact Your Lab
Keep charging for sample collection — for now. The feds have a lot to say about cover... Read more
See How MPFS Final Rule and Congressional Action Impact Your Lab
Keep charging for sample collection — for now. The feds have a lot to say about cover... Read more
Reader Questions:
Notice FISH Urinary Specimen Distinction
Question: Our pathologist performed computer-assisted FISH testing using three probes... Read more
Notice FISH Urinary Specimen Distinction
Question: Our pathologist performed computer-assisted FISH testing using three probes... Read more
Reader Questions:
Master MUE Limits and Options
Question: Could you please clarify what “MUE” is and how it might impact my codin... Read more
Master MUE Limits and Options
Question: Could you please clarify what “MUE” is and how it might impact my codin... Read more
Reader Questions:
Distinguish TURP Specimen
Question: The pathologist received three pieces of prostate tissue in a single contai... Read more
Distinguish TURP Specimen
Question: The pathologist received three pieces of prostate tissue in a single contai... Read more
You Be the Coder:
Build Vitamin B12 Testing Glossary
Question: The lab receives an order for serum transcobalamin and performs a radiobind... Read more
Build Vitamin B12 Testing Glossary
Question: The lab receives an order for serum transcobalamin and performs a radiobind... Read more
CPT® 2022:
Focus on Microbiology Guideline Changes
See what disagreement over a blood pathogen code will cost you. With attention to CPT® M... Read more
Focus on Microbiology Guideline Changes
See what disagreement over a blood pathogen code will cost you. With attention to CPT® M... Read more
Anatomic Pathology:
Get to the Bottom of Lymph-Node Coding Hesitation
Parse ‘sentinel node' terminology to get the pay you deserve. If seeing “lymph node... Read more
Get to the Bottom of Lymph-Node Coding Hesitation
Parse ‘sentinel node' terminology to get the pay you deserve. If seeing “lymph node... Read more
Lab Management:
Hone Your Compliance Skills With These Appeals Strategies
Focus on payer advice to direct your actions. You should be glad you can appeal a claim ... Read more
Hone Your Compliance Skills With These Appeals Strategies
Focus on payer advice to direct your actions. You should be glad you can appeal a claim ... Read more
Reader Questions:
Capture Microbiology Steps for Complete Coding
Question: The lab received an infected tissue specimen and smeared a slide for a Gram stai... Read more
Capture Microbiology Steps for Complete Coding
Question: The lab received an infected tissue specimen and smeared a slide for a Gram stai... Read more
Reader Questions:
Close the Door on Keylogger Software
Question: What exactly is keylogger software, and how can we avoid this type of security b... Read more
Close the Door on Keylogger Software
Question: What exactly is keylogger software, and how can we avoid this type of security b... Read more
You Be the Coder:
Gather Clinical Details for Ulcer Coding
Question: The pathologist examined a duodenum biopsy from an esophagogastroduodenoscopy (E... Read more
Gather Clinical Details for Ulcer Coding
Question: The pathologist examined a duodenum biopsy from an esophagogastroduodenoscopy (E... Read more
CPT® 2022:
Here’s Why Adding ‘Each Antibody’ Is a Welcome Change
Master immunology code additions. With 15 new codes for immunology tests in CPT® 2022, y... Read more
Here’s Why Adding ‘Each Antibody’ Is a Welcome Change
Master immunology code additions. With 15 new codes for immunology tests in CPT® 2022, y... Read more
Prostate Assay:
Answer 3 Questions for Perfect PSA Test Claims
The reason for the test will guide your choices. When your lab gets a request for a pros... Read more
Answer 3 Questions for Perfect PSA Test Claims
The reason for the test will guide your choices. When your lab gets a request for a pros... Read more
CERT Report:
Alert Physicians to Avoid Common Lab-Test Order Errors
Fill holes in documentation. Lab test orders are one area that frequently caused errors d... Read more
Alert Physicians to Avoid Common Lab-Test Order Errors
Fill holes in documentation. Lab test orders are one area that frequently caused errors d... Read more
Reader Questions:
Follow These Faxing Precautions
Question: What are the HIPAA rules regarding using a fax to transmit lab test results? Ca... Read more
Follow These Faxing Precautions
Question: What are the HIPAA rules regarding using a fax to transmit lab test results? Ca... Read more
Reader Questions:
Locate and Prioritize PLA Codes
Question: I'm aware that PLA codes take priority over 80000-level lab codes, but how ... Read more
Locate and Prioritize PLA Codes
Question: I'm aware that PLA codes take priority over 80000-level lab codes, but how ... Read more
Reader Questions:
Use CMS-838 For Return Payment
Question: How can we be sure we're refunding the correct amount when a claims process... Read more
Use CMS-838 For Return Payment
Question: How can we be sure we're refunding the correct amount when a claims process... Read more
Reader Questions:
See Medicare Drug-Test ‘G’ Codes
Question: Our lab performed a drug test using LC/MS-MS for three analgesic drug class... Read more
See Medicare Drug-Test ‘G’ Codes
Question: Our lab performed a drug test using LC/MS-MS for three analgesic drug class... Read more
You Be the Coder:
Details Determine Thyroid Coding
Question: Our pathologist received a hemithyroidectomy specimen with a request for fr... Read more
Details Determine Thyroid Coding
Question: Our pathologist received a hemithyroidectomy specimen with a request for fr... Read more