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Pathology/Lab Coding Alert

CPT 2001:
Know Significant Pathology/Laboratory Coding Changes for Proper Reimbursement
CPT 2001 contains many changes for pathology/laboratory coding. The section includes 57 ne... Read more
Optimize Payment:
Understand Different Types of Ovarian Cysts
Finding the correct procedure code and diagnosis code for ovarian cysts can be a challen... Read more
Reader Question:
Professional Services for Decalcification
Question: When submitting multiple pieces from a bone specimen, how do we bill profession... Read more
Reader Question:
Aspirates
Question: Our pathology group often provides a pathologist for immediate cytohistologic ... Read more
You Be the Coder:
Hemoccult Test
Question: Can the physician bill for a single determination hemoccult test collected and... Read more
Reimbursement for New Pathology Correct Coding Initiative Edits Requires Modifier
The number of pathology/laboratory edit pairs has more than doubled in Version 6.3 of th... Read more
Unsupported Claim Denials to Stop as Black Box Edits Recalled
The Health Care Financing Administration (HCFA) has instructed local carriers that it di... Read more
News Brief:
OIG to Target Lab Certification, ABNs and More
The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS... Read more
Reader Question:
Thymus Gland
Question: Occasionally, one of our pediatric cardiothoracic surgeons sends us a normal thy... Read more
Reader Question:
Modifier -91
Question: What modifier should we use when multiples of the same CPT code are billed for a... Read more
Reader Question:
Skin Diagnosis
Question: A pathologist receives a skin specimen for diagnosis and frozen section evaluati... Read more
Reader Question:
Level IV Pathology
Question: We received a labeled right axillary mass, which consists of an 8.5-by-4.0-cm el... Read more
Reader Question:
Soft Palate and Uvula
Question: We received a specimen identified as tonsils, soft palate and uvula. I know that... Read more
You Be the Coder:
Dermatology Specimens
Question: We receive hundreds of dermatology specimens every day. Some take considerably m... Read more
Careful Documentation Ensures Reimbursement For Fecal Occult Blood Test
Coding for fecal occult blood tests (FOBT) involves understanding the various tests and t... Read more
Capture Reimbursement With Medicare ABN
Unless youre diligent about seeing that you have a signed waiver of liability statement fr... Read more
How New APCs Affect Payment For Pathology Services
Last month we looked at how the outpatient prospective payment system will impact billin... Read more
Reader Question:
Surgical Pathology
Question: We received three numbered containers. The contents of #1 was identified as left... Read more
Reader Question:
Molecular Diagnostic Tests
Question: Our lab sometimes runs multiple molecular diagnostic tests for the same patient ... Read more
You Be the Coder:
Skin Lesion
Question: What would be the appropriate diagnosis and procedure codes for the re-excisio... Read more
Capture Full Reimbursement for Pathology Consultation During Surgery
Coding for pathology consultation during surgery can be a source of confusion for many. ... Read more
Continue to Bill Medicare for TC of Outpatient Services
Independent laboratories have a temporary reprieve. They can continue billing the techni... Read more
Avert Improper Denials for Interpretation of Pap Smears
Some pathologists are getting claim denials for interpretation of abnormal Pap smears (e.g... Read more
Reader Question:
Tonsil Resection
Question: I have a cancerous tonsil resection along with a radical neck procedure in a sep... Read more
You Be the Coder:
Prostate Biopsies
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Bone Sampling Codes:
Optimize Billing for Aspiration and Bone or Bone-marrow Biopsy Services
"Some of the confusion regarding appropriate coding for various bone sampling and e... Read more
Minimize Claim Denials by Avoiding Truncated Codes
The new ICD9 Codes that will go into effect Oct. 1, 2000, include the expansion of sever... Read more
Reader Question:
Lipoma of the Cord
Question: A specimen is submitted as a lipoma of the cord. It is, but it is also a hernia ... Read more
Reader Question:
Microscopic Report
Question: Several of the pathologists within our group recently submitted reports without ... Read more
Reader Question:
Hysterectomy
Question: We are concerned with pathology billing for a hysterectomy, with or without ov... Read more
Reader Question:
LEEP
Question: A LEEP (loop electrocautery excision procedure) is not just a colposcopic biopsy... Read more
You Be the Coder:
Skin Lesions
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Gain Rightful Reimbursement by Coding All the Steps in Stem Cell Treatment
Pathologists and laboratories specializing in hematology may work closely with oncologists... Read more
Understanding Medicares CCI Is Powerful Compliance Tool
Unbundling breaking down a single procedure into its component parts and billing for add... Read more
Know the Five Key Steps to Successfully Appeal Denials
Insurance denials for ethically claimed services are an irritating and somewhat frequent o... Read more
Reader Question:
Insufficient Specimen
Question: A pathologist receives a slide, which is said to be prepared from a breast fine ... Read more
Reader Question:
Fungus ID
Question: If we do a urine culture or a wound culture, and a fungus identification, how wo... Read more
You Be the Coder:
Trichrome Stain
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Avoid Denials for Prostate Cancer Screening With Appropriate HCPCS Codes
Medicare began coverage for two procedures for prostate cancer screening on Jan. 1, 2000... Read more
Clinical Pathology Consultation Codes:
Understanding How to Use Them Is Key to Reimbursement
Clinical laboratory test results often are returned as a computer-generated report or, und... Read more
Optimize Payment by Correctly Coding for the 88160 Family
Seemingly an oasis for lab personnel and pathologists toiling through a tray of slides on ... Read more
Reader Question:
FNA Billing
Question: During the fine needle aspiration (FNA) procedure, usually the aspirate is fir... Read more
Reader Question:
Specimen Evaluation
Question: What is the correct code for evaluation of a capsule surrounding a breast implan... Read more
Reader Question:
85060 Billing Requirements
Question: An 80-year-old Medicare patient has an abnormal CBC (complete blood count). The ... Read more
Reader Question:
Bone Marrow
Question: In the answer to a reader question, Bone Marrow Exam, on page 32 the April 2000 ... Read more
Get Paid for Sentinel Lymph Node Biopsy
CPT 2000 does not contain a specific procedural code for sentinel lymph node biopsy. That ... Read more
AHIMA Releases New Standards of Ethical Coding
Proper coding for neurosurgical procedures and practices requires up-to-the-minute infor... Read more
HCFA Proposes Uniform Policies For Clinical Diagnostic Labs
A proposed rule by the Health Care Financing Administration (HCFA) could have a signific... Read more
News Brief:
Look for Corrections to National CCI Version 6.1
Due to a large number of errors, the implementation of the national Correct Coding Initi... Read more
Reader Question:
Cervix Cone Biopsies
Question: We frequently receive cervix cone biopsies. The inner and outer cone are in sepa... Read more
Reader Question:
Cryopreservation of Stem Cells
Question: When peripheral blood stem cells are removed from a patient by apheresis, what c... Read more
Reader Question:
Bronchial Washings
Question: What is the correct code for bronchial washings? When we receive documentation f... Read more
You Be the Coder:
Bone Marrow Aspiration and Biopsy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
How a Lab Can Avoid Medicare Denials for Pap Smears
Medicares directives for reporting Pap smears can be confusing, but understanding and co... Read more
Compliance Programs Impact Coding and Billing
This issue of Pathology/Lab Coding Alert includes an insert that is a description of the... Read more
Eliminate the Confusion of Streptoccal Detection Codes
Coding for streptococcal detection methods can be confusing, with multiple references sc... Read more
Reader Question:
Pathological Diagnoses
Question: How do I code specimens with no pathological diagnoses, especially when the proc... Read more
Reader Question:
Consult vs. Substitute Physician
Question: We have a confusing billing situation in which one pathologist is covering froze... Read more
Reader Question:
Tonsillectomy
Question: Recently, one of our insurance carriers denied claims for gross examination only... Read more
Reader Question:
Bone Marrow Exam
Question: If examination of aspirate from bone marrow needle biopsy (85102) requires the p... Read more
You Be the Coder:
Advanced Benficiary Notification
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Maximize Payback with Fine-needle Aspiration Coding
Fine-needle aspiration (FNA) used for the diagnosis of suspicious lesions is growing rap... Read more
Decide Which ICD-9 Codes Best Comply With the Guidelines
Both compliance and reimbursement can hinge on the correct assignment of ICD-9-CM codes.... Read more
Collect for E/M Services Provided With Apheresis
Usually, the pathologist responsible for apheresis services also provides evaluation and... Read more
You be the Coder:
Physician's Office or Lab - Who Bills?
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Reader Question:
Organ and Disease Panel Codes
Question: I read in your January issue (CPT 2000 Revises Organ- or Disease-Oriented panels... Read more
Reader Question:
Sinus Coding
Question: What is the proper CPT code for right and left maxillary sinus contents submi... Read more
Reader Question:
Surgical Pathology Specimens
Question: How should I code surgical pathology specimens that did not survive processing, ... Read more
Reader Question:
Colon Polyps
Question: How should I code three colon polyps in one container with no identification as ... Read more
Reader Question:
Breast Biopsies
Question: Which types of breast biopsies are CPT 88305 and which are 88307?Anonymous Texa... Read more
Reader Question:
Pathology Specimens
Question: We received specimens that include the lobe of a lung and different level biopsi... Read more
Reader Question:
Radical Nephrectomy
Question: On a radical nephrectomy specimen, can an additional CPT 88307 be charged if th... Read more
Reader Question:
Endometrial Carcinoma
Question: My question involves a specimen of uterus with tubes and ovaries. The diagnosis ... Read more
Tactics to Avoid Unbundling Specimen Coding
Understanding when tissue samples represent different specimens is the key to correct co... Read more
Correctly Reporting Technical And Professional Components
The organizational structure of your practice or lab is key to determining how to bill pro... Read more
News Brief:
No More Secret 'Black Box' Pathology Edits
The Health Care Financing Administration (HCFA) wants to make all claim edits used by Me... Read more
Reader Question:
Autologous Plateletgel Therapy
Question: We are looking for the specific CPT and HCFA insurance and Medicare billing co... Read more
Reader Question:
Aspiration and Interpretation
Question: We are having trouble with BCBS of South Carolina about using CPT codes 88170 an... Read more
Reader Question:
Mastectomy and Lymph Nodes
Question: What is/are the code(s) for mastectomy received in one container and lymph nodes... Read more
You Be the Coder:
Coding FNA With Multiple Specimens
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
CPT 2000 Revises Organ- or Disease-Oriented panels
The primary revisions to the CPT Codes 2000 pathology and laboratory codes are contained... Read more
Modifier 59, How to Avoid Confusion in Reporting Multiple Procedures
Correctly using modifier -59 (distinct procedural service) can help prevent denials for ... Read more
Get Proper Reimbursement for Consultations on Referred Material
When material is referred from another pathologist or facility, the use of CPT codes 88321... Read more
Cut Through the Confusion of Pap Guidelines
CPT 1999 ushered in completely new and revised cytopathology codes for Pap screenings, a... Read more
Reader Question:
Different Diagnosis
Question: What do I do when a pathology procedure that is carried out is not indicated b... Read more
You Be the Coder:
Pathology Surgery Exam
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Available Years:  2000