Pathology/Lab Coding Alert
CPT® 2025:
Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is o... Read more
Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is o... Read more
ICD-10-CM Coding:
4 Tips Will Put You at the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you're new to coding neoplasms, the IC... Read more
4 Tips Will Put You at the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you're new to coding neoplasms, the IC... Read more
HIPAA:
Examine These 3 Cases, Stay Safe from HIPAA Violations
Avoid the fate of these healthcare entities with solid training and compliance strategies... Read more
Examine These 3 Cases, Stay Safe from HIPAA Violations
Avoid the fate of these healthcare entities with solid training and compliance strategies... Read more
You Be the Coder:
Focus RSV Coding With These Tips
Question: The physician orders an RSV test for a 2-year-old patient presenting with s... Read more
Focus RSV Coding With These Tips
Question: The physician orders an RSV test for a 2-year-old patient presenting with s... Read more
Reader Questions:
Get Details For Accurate BRCA1 Coding
Question: I'm doing billing for a lab that reported performing a “BRCA1 molecular ... Read more
Get Details For Accurate BRCA1 Coding
Question: I'm doing billing for a lab that reported performing a “BRCA1 molecular ... Read more
Reader Questions:
Dx Specifics Drive Drug Test Coding
Question: We received an order for a leukemia patient to test the blood specimen for... Read more
Dx Specifics Drive Drug Test Coding
Question: We received an order for a leukemia patient to test the blood specimen for... Read more
Reader Questions:
Don’t Let This Misstep Lower Your Ovary Pay
Question: The surgeon submitted a right oophorectomy specimen in one container with t... Read more
Don’t Let This Misstep Lower Your Ovary Pay
Question: The surgeon submitted a right oophorectomy specimen in one container with t... Read more
News You Can Use:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Service... Read more
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Service... Read more
Procedure Coding:
Pick Prostate Cancer Biopsy Codes Precisely
Know when to go beyond 55700. Confused as to which code to use when your provider perform... Read more
Pick Prostate Cancer Biopsy Codes Precisely
Know when to go beyond 55700. Confused as to which code to use when your provider perform... Read more
Audits:
Establish Practice Protocols For Addressing A TPE Audit
Hint: Look at your MAC's focus to troubleshoot internal issues. Whether you've already ... Read more
Establish Practice Protocols For Addressing A TPE Audit
Hint: Look at your MAC's focus to troubleshoot internal issues. Whether you've already ... Read more
Reader Questions:
Decipher High-Risk HPV Test Codes
Question: Our lab performs high-risk HPV testing for cervical specimens, but I'm not... Read more
Decipher High-Risk HPV Test Codes
Question: Our lab performs high-risk HPV testing for cervical specimens, but I'm not... Read more
Reader Questions:
Focus ER/PR Coding and More
Question: When we perform tumor immunohistochemistry for ER/PR status for breast tiss... Read more
Focus ER/PR Coding and More
Question: When we perform tumor immunohistochemistry for ER/PR status for breast tiss... Read more
Reader Questions:
Do This to Ensure Mole Exam Pay
Question: Our pathologist diagnosed a skin specimen from the patient's right cheek a... Read more
Do This to Ensure Mole Exam Pay
Question: Our pathologist diagnosed a skin specimen from the patient's right cheek a... Read more
You Be the Coder:
Pinpoint Coding for Esophageal Bx with GERD
Question: The pathologist examined two distinct specimens from an EGD procedure for a... Read more
Pinpoint Coding for Esophageal Bx with GERD
Question: The pathologist examined two distinct specimens from an EGD procedure for a... Read more
News You Can Use:
Get a Jump-Start on CPT® 2025
See which updates are most likely to affect the services you code. The May 2024 meeting o... Read more
Get a Jump-Start on CPT® 2025
See which updates are most likely to affect the services you code. The May 2024 meeting o... Read more
Coding Quiz:
Take This Quiz, Become a Urine Culture Coding Ace
Do you know the difference between presumptive and definitive identification? You may th... Read more
Take This Quiz, Become a Urine Culture Coding Ace
Do you know the difference between presumptive and definitive identification? You may th... Read more
Revenue Cycle:
Hear From Those Affected by the Change Healthcare Outage
Reinforce your skills with paper-based claims. More than four months have passed since m... Read more
Hear From Those Affected by the Change Healthcare Outage
Reinforce your skills with paper-based claims. More than four months have passed since m... Read more
Coding Quiz Answers:
Check Your Answers to Our Urine Culture Coding Quiz
And add these ICD-10-CM codes to your urine testing knowledge base Answer 1: Presumptive... Read more
Check Your Answers to Our Urine Culture Coding Quiz
And add these ICD-10-CM codes to your urine testing knowledge base Answer 1: Presumptive... Read more
Reader Questions:
Master Technical/Professional Reporting for Labs
Question: Could you please explain how to use modifiers 26 and TC for lab and pathol... Read more
Master Technical/Professional Reporting for Labs
Question: Could you please explain how to use modifiers 26 and TC for lab and pathol... Read more
Reader Questions:
Focus Liver and Lymph Coding With This Case
Question: The pathologist received a liver wedge biopsy specimen along with a lymph n... Read more
Focus Liver and Lymph Coding With This Case
Question: The pathologist received a liver wedge biopsy specimen along with a lymph n... Read more
Reader Questions:
See How Dx and Modifier Errors Can Derail Reimbursement
Question: The lab performed a urinalysis with microscopic examination for a patient w... Read more
See How Dx and Modifier Errors Can Derail Reimbursement
Question: The lab performed a urinalysis with microscopic examination for a patient w... Read more
You Be the Coder:
Distinguish Ab/Ag Tests for Lyme Disease Infectious Agent
Question: Our lab performed an antibody test for Borrelia burgdorferi for a patient w... Read more
Distinguish Ab/Ag Tests for Lyme Disease Infectious Agent
Question: Our lab performed an antibody test for Borrelia burgdorferi for a patient w... Read more
Molecular Pathology:
Get the Answers to Your Frequently Asked Genetic Testing Questions
Here's how to make your way through the CPT® molecular pathology code set. “The geneti... Read more
Get the Answers to Your Frequently Asked Genetic Testing Questions
Here's how to make your way through the CPT® molecular pathology code set. “The geneti... Read more
Billing:
Address These Key Fields, Complete ABNs With Ease
Don't forget that every ABN form must be one single page. As every pathology practice an... Read more
Address These Key Fields, Complete ABNs With Ease
Don't forget that every ABN form must be one single page. As every pathology practice an... Read more
Compliance:
Stay on the Right Side of the Stark Law With Key Strategies
Scrutinize your referrals to avoid inadvertent violations. Every lab has seen news headli... Read more
Stay on the Right Side of the Stark Law With Key Strategies
Scrutinize your referrals to avoid inadvertent violations. Every lab has seen news headli... Read more
Reader Questions:
Rely on These Tips for Bone Cases
Question: During hip replacement surgery for a patient with severe osteoporosis, the surge... Read more
Rely on These Tips for Bone Cases
Question: During hip replacement surgery for a patient with severe osteoporosis, the surge... Read more
Reader Questions:
Focus Blood Type Reporting
Question: We received a paternal blood specimen for blood typing as part of the neona... Read more
Focus Blood Type Reporting
Question: We received a paternal blood specimen for blood typing as part of the neona... Read more
You Be the Coder:
Be Wise to Zika Virus Coding
Question: Our lab performed a blood test for Zika virus antigen detection for a patie... Read more
Be Wise to Zika Virus Coding
Question: Our lab performed a blood test for Zika virus antigen detection for a patie... Read more
News You Can Use:
Sneak a Peek at the January 2025 CPT® Path/Lab Changes
Plus, know where to find the latest PLA and MAAA code updates. Pathology and laboratory s... Read more
Sneak a Peek at the January 2025 CPT® Path/Lab Changes
Plus, know where to find the latest PLA and MAAA code updates. Pathology and laboratory s... Read more
Artificial Intelligence:
Streamline Lab Processes With These 5 AI Hacks
Find out if AI will save staff time for more important tasks. You may think that your lab... Read more
Streamline Lab Processes With These 5 AI Hacks
Find out if AI will save staff time for more important tasks. You may think that your lab... Read more
Cybersecurity:
Protect Your Lab With These 5 Must-Know Cybersecurity Facts
Avoid ransomware, email hacks and more by mastering the nuances of cybersecurity. Ever s... Read more
Protect Your Lab With These 5 Must-Know Cybersecurity Facts
Avoid ransomware, email hacks and more by mastering the nuances of cybersecurity. Ever s... Read more
Reader Questions:
Drill Down to CMV Test Details for Proper Coding
Question: I'm new to lab coding; could you help me understand how to report a blood t... Read more
Drill Down to CMV Test Details for Proper Coding
Question: I'm new to lab coding; could you help me understand how to report a blood t... Read more
Reader Questions:
Avoid These FNA Coding Pitfalls
Question: During a thyroid lesion FNA procedure, the surgeon asks our pathologist to ... Read more
Avoid These FNA Coding Pitfalls
Question: During a thyroid lesion FNA procedure, the surgeon asks our pathologist to ... Read more
Reader Questions:
Conquer HLA Reporting Confusion
Question: The lab I code for does HLA typing and compatibility testing. Could you ple... Read more
Conquer HLA Reporting Confusion
Question: The lab I code for does HLA typing and compatibility testing. Could you ple... Read more
You Be the Coder:
Documenting Separate Specimens Warrants More Pay
Question: Our pathologist received a partial pancreatectomy for diagnosis. The surgeo... Read more
Documenting Separate Specimens Warrants More Pay
Question: Our pathologist received a partial pancreatectomy for diagnosis. The surgeo... Read more
CPT® Coding:
Remove These 2 Myths for Super-Clean Skin Biopsy Claims
And use this clever coding trick when your provider performs multiple biopsies. Knowing h... Read more
Remove These 2 Myths for Super-Clean Skin Biopsy Claims
And use this clever coding trick when your provider performs multiple biopsies. Knowing h... Read more
Practice Safety:
Keep Your Staff, Patients Safe With These Lab Precautions
Hint: Follow OSHA, but also have policies in place customized to your practice. Every l... Read more
Keep Your Staff, Patients Safe With These Lab Precautions
Hint: Follow OSHA, but also have policies in place customized to your practice. Every l... Read more
Reimbursement:
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim... Read more
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim... Read more
Reader Questions:
Focus Benign Breast Dx Coding
Question: Our pathologist examined a breast biopsy and reported the diagnosis as “f... Read more
Focus Benign Breast Dx Coding
Question: Our pathologist examined a breast biopsy and reported the diagnosis as “f... Read more
Reader Questions:
Get Specific With X{ESPU} Modifiers
Question: What are some pathology or laboratory examples of when we might use one of ... Read more
Get Specific With X{ESPU} Modifiers
Question: What are some pathology or laboratory examples of when we might use one of ... Read more
Reader Questions:
Find Escape From Denied Pap Claim
Question: The lab performed a liquid-based Pap test that the physician ordered, which... Read more
Find Escape From Denied Pap Claim
Question: The lab performed a liquid-based Pap test that the physician ordered, which... Read more
You Be the Coder:
Capture Each Step of This Renal Case
Question: During a renal biopsy procedure for a patient with chronic kidney symptoms,... Read more
Capture Each Step of This Renal Case
Question: During a renal biopsy procedure for a patient with chronic kidney symptoms,... Read more
CPT® Coding:
Know How to Use the Pathology Consultation Codes
Here's how to get time on your side. In 2021, the Centers for Medicare & Medicaid Ser... Read more
Know How to Use the Pathology Consultation Codes
Here's how to get time on your side. In 2021, the Centers for Medicare & Medicaid Ser... Read more
Compliance:
Follow These 3 Best Practices to Create Compliant Documentation
Don't forget to add the date when you create a documentation addendum. Every coding profe... Read more
Follow These 3 Best Practices to Create Compliant Documentation
Don't forget to add the date when you create a documentation addendum. Every coding profe... Read more
HIPAA:
Learn These 3 Truths and 3 Myths about PHI
Hint: De-identifying records may allow you to scrub PHI from them. From patient names t... Read more
Learn These 3 Truths and 3 Myths about PHI
Hint: De-identifying records may allow you to scrub PHI from them. From patient names t... Read more
Reader Questions:
Round Up H. Pylori Coding Options
Question: When our lab performs a test to detect H. pylori infection, how can I dete... Read more
Round Up H. Pylori Coding Options
Question: When our lab performs a test to detect H. pylori infection, how can I dete... Read more
Reader Questions:
Focus Breast Cancer Dx Coding
Question: The pathologist diagnosed inflammatory breast cancer. Should we report this... Read more
Focus Breast Cancer Dx Coding
Question: The pathologist diagnosed inflammatory breast cancer. Should we report this... Read more
Reader Questions:
Choose CLIA Category Correctly With These Resources
Question: How can I find out the categorization of a lab test under CLIA? Minnesota ... Read more
Choose CLIA Category Correctly With These Resources
Question: How can I find out the categorization of a lab test under CLIA? Minnesota ... Read more
You Be the Coder:
Lookout for ‘Sentinel’ Lymph Nodes
Question: As part of a partial mastectomy case, the surgeon submits a separate contai... Read more
Lookout for ‘Sentinel’ Lymph Nodes
Question: As part of a partial mastectomy case, the surgeon submits a separate contai... Read more
Medicare:
3 Top Takeaways From the Newest PLA NCCI Edits
Discover which code pairs are now open to separate payment. Medicare recently added more ... Read more
3 Top Takeaways From the Newest PLA NCCI Edits
Discover which code pairs are now open to separate payment. Medicare recently added more ... Read more
Modifiers:
Master Modifier 26, TC Coding With These 5 Tips
Hint: These modifiers can't separate every lab service. When your pathologist interpre... Read more
Master Modifier 26, TC Coding With These 5 Tips
Hint: These modifiers can't separate every lab service. When your pathologist interpre... Read more
HIPAA:
Maintain These HIPAA Best Practices, Avoid These Common Violations
Latest HIPAA report highlights how practices let PHI fall through the cracks. If your la... Read more
Maintain These HIPAA Best Practices, Avoid These Common Violations
Latest HIPAA report highlights how practices let PHI fall through the cracks. If your la... Read more
Reader Questions:
Recognize Multiplex Parameters
Question: The lab performs a triple antibody stain on a melanoma specimen using SOX1... Read more
Recognize Multiplex Parameters
Question: The lab performs a triple antibody stain on a melanoma specimen using SOX1... Read more
Reader Questions:
Focus MRI Pre-Procedure Lab Test Coding
Question: How should we code a creatinine test ordered to evaluate kidney function b... Read more
Focus MRI Pre-Procedure Lab Test Coding
Question: How should we code a creatinine test ordered to evaluate kidney function b... Read more
Reader Questions:
Don’t Miss Antibody-Specific Codes
Question: A clinician ordered antibody tests for ANCA and ASCA to help distinguish f... Read more
Don’t Miss Antibody-Specific Codes
Question: A clinician ordered antibody tests for ANCA and ASCA to help distinguish f... Read more
You Be the Coder:
Sidestep Mohs Bundling Pitfalls
Question: We have a dermatology client who, when performing a Mohs procedure, sometim... Read more
Sidestep Mohs Bundling Pitfalls
Question: We have a dermatology client who, when performing a Mohs procedure, sometim... Read more
CPT® Updates:
Stay Ahead of the 2024 CPT® MoPath Coding Updates
AMA code descriptors acknowledge people-first language. In 2010, Congress passed Rosa's L... Read more
Stay Ahead of the 2024 CPT® MoPath Coding Updates
AMA code descriptors acknowledge people-first language. In 2010, Congress passed Rosa's L... Read more
Modifiers:
Know These Modifier QW Dos and Don’ts
Hint: Check the CLIA list every time you're submitting a new lab test. Some coding modif... Read more
Know These Modifier QW Dos and Don’ts
Hint: Check the CLIA list every time you're submitting a new lab test. Some coding modif... Read more
Practice Management:
Jump-Start Your Error Reduction Program With Internal Audits
Lab tests among the most frequent Part B errors last year, CMS says. If you're not fond ... Read more
Jump-Start Your Error Reduction Program With Internal Audits
Lab tests among the most frequent Part B errors last year, CMS says. If you're not fond ... Read more
Reader Questions:
Zero In on Best Breast Tissue Specimen Choice
Question: The pathologist received a breast tissue specimen that the surgeon labeled,... Read more
Zero In on Best Breast Tissue Specimen Choice
Question: The pathologist received a breast tissue specimen that the surgeon labeled,... Read more
Reader Questions:
Sidestep 26 With Technical Pap Code
Question: We perform Pap tests that use computer-assisted screening of liquid-based s... Read more
Sidestep 26 With Technical Pap Code
Question: We perform Pap tests that use computer-assisted screening of liquid-based s... Read more
Reader Questions:
Look for Modifier 91 to Clarify Case
Question: A physician ordered a D-dimer test for a patient suspected of having a str... Read more
Look for Modifier 91 to Clarify Case
Question: A physician ordered a D-dimer test for a patient suspected of having a str... Read more
You Be the Coder:
Examine CF Genetic Testing Coverage
Question: Our lab performs genetic testing for cystic fibrosis looking only at CFTR c... Read more
Examine CF Genetic Testing Coverage
Question: Our lab performs genetic testing for cystic fibrosis looking only at CFTR c... Read more
CPT® 2024:
New Lab Codes Describe Diagnostic Opportunities
Look for immunology, microbiology, chemistry, and more. As clinicians test for myasthenia... Read more
New Lab Codes Describe Diagnostic Opportunities
Look for immunology, microbiology, chemistry, and more. As clinicians test for myasthenia... Read more
2024 Final Rule:
Highlight Physician Fee Schedule Relevance to Your Lab
Gear up for more than payment changes. The final tally is in — pathologists can expec... Read more
Highlight Physician Fee Schedule Relevance to Your Lab
Gear up for more than payment changes. The final tally is in — pathologists can expec... Read more
Prepare for Possible CLIA Update
See RFI response in MPFS final rule. Having received stakeholder comments to a request fo... Read more
See RFI response in MPFS final rule. Having received stakeholder comments to a request fo... Read more
Reader Question:
Refresh Drug Test Coding Skills
Question: Our lab performs a broad drug class screening test using liquid chromatogra... Read more
Refresh Drug Test Coding Skills
Question: Our lab performs a broad drug class screening test using liquid chromatogra... Read more
Reader Question:
Untangle IHC Stain Conundrum
Question: The pathologist evaluated slides from two blocks of a breast biopsy specime... Read more
Untangle IHC Stain Conundrum
Question: The pathologist evaluated slides from two blocks of a breast biopsy specime... Read more
Reader Question:
Distinguish HIPAA Terms
Question: Could you please explain the difference between “consent” and “author... Read more
Distinguish HIPAA Terms
Question: Could you please explain the difference between “consent” and “author... Read more
You Be the Coder:
Avoid This Breast Cytology Coding Trap
Question: The pathologist performed a puncture aspiration of a cyst in the patient's ... Read more
Avoid This Breast Cytology Coding Trap
Question: The pathologist performed a puncture aspiration of a cyst in the patient's ... Read more
Path/Lab Coding:
Focus Panel Test Coding for UTI Scenario
Question: During a second course of antibiotics for a urinary tract infection (UTI), the c... Read more
Focus Panel Test Coding for UTI Scenario
Question: During a second course of antibiotics for a urinary tract infection (UTI), the c... Read more
Path/Lab Coding:
Avoid Breast FNA Coding Pitfalls
Question: The pathologist extracted fluid during two fine needle aspiration (FNA) passes f... Read more
Avoid Breast FNA Coding Pitfalls
Question: The pathologist extracted fluid during two fine needle aspiration (FNA) passes f... Read more
Path/Lab Coding:
Get The Answers to Your Frequently Asked PSA Test Questions
Understand medical necessity to arrive at the correct test code. Your lab probably gets f... Read more
Get The Answers to Your Frequently Asked PSA Test Questions
Understand medical necessity to arrive at the correct test code. Your lab probably gets f... Read more
Path/Lab Coding:
Look for Coverage Guidance in NCDs, LCDs
Question: How can I find information about Medicare coverage for lab and pathology procedu... Read more
Look for Coverage Guidance in NCDs, LCDs
Question: How can I find information about Medicare coverage for lab and pathology procedu... Read more
Path/Lab Coding:
Let Z Codes Pave the Way for Some Lab Tests
Question: As a lab coder, we use the diagnosis assigned by the ordering physician when sub... Read more
Let Z Codes Pave the Way for Some Lab Tests
Question: As a lab coder, we use the diagnosis assigned by the ordering physician when sub... Read more
Path/Lab Coding:
Apply the Latest PLA Updates for Cutting Edge Services
One specialty makes up almost half of the October codes. The October update to Proprietar... Read more
Apply the Latest PLA Updates for Cutting Edge Services
One specialty makes up almost half of the October codes. The October update to Proprietar... Read more
Path/Lab Coding:
Get Ready for CRC Screening Under 2025 Medicare Rules
Question: I've heard there are recent changes to Medicare coverage for colorectal cancer (... Read more
Get Ready for CRC Screening Under 2025 Medicare Rules
Question: I've heard there are recent changes to Medicare coverage for colorectal cancer (... Read more
Path/Lab Coding:
Distinguish Bone Codes for Accurate Payment
Question: Our pathologist examines many specimens of bones, joints, and various bony fragm... Read more
Distinguish Bone Codes for Accurate Payment
Question: Our pathologist examines many specimens of bones, joints, and various bony fragm... Read more