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Pathology/Lab Coding Alert

Don't Let NCCI 9.3 Surgical Pathology Edits Stop You
You can still report separate cytopathology You shouldn't be reporting the CPT 881... Read more
You Can Get NCCI Edits Free Online
After years of paying to learn about new coding restrictions CMS has placed on your lab, y... Read more
Learn NCCI's Latest Bundles - and How to Override Them
Heads up for a new list of codes that Medicare says you can't report together withou... Read more
Here's How to Improve Your Surgical Pathology Pay
Specimens, blocks, smears or stains - just what is the unit of service for pathology pro... Read more
Did You Know Frozen Sections Break the Rules?
You keep reminding yourself that you can't code per block. And you're right - for cytopath... Read more
Reader Question:
Separate Bone Marrow Interpretation, Collection
Question: A patient with myeloma was having an unrelated knee replacement surgery. During ... Read more
Reader Question:
Use HPV Diagnosis as the Reason for the Test
Question: Our lab performed a screening thin-layer preparation Pap smear ordered for a low... Read more
Reader Question:
Bethesda and ICD-9-CM Still Don't Match
Question: I've heard that we should report Bethesda's Pap categories of ASCUS and ASCH usi... Read more
You Be the Coder:
Medicare Changes Fecal Leukocyte Code
Question: We used to bill Medicare for fecal leukocyte exams using G0026, but that code wa... Read more
Are You Wondering How to Code Cervical Cancer Lab Tests?
Follow these 5 steps to improve your Pap reimbursement With more than two dozen proced... Read more
Get the Pay You Deserve for Pap Tests
You might report the proper procedure code, but if you don't get a signed advance benefici... Read more
Handy Reference Chart:
Cervical Cytology At-a-Glance
With 25 codes to choose from, you'll report only one, maybe two, every time your lab... Read more
New Guidelines Could Mean Fewer Paps in Your Lab's Future
ACOG makes changes   The type and volume of cervical cytology testing your lab do... Read more
Reader Question:
You Can't Code for Calculated LDL
Question: Our lab wants to add LDL to the lipid panel so when physicians order the panel, ... Read more
Reader Question:
Use Colon Polyp as Reason for Pathology Exam
Question: I'm billing for the pathologist's evaluation of a colon polyp under the followin... Read more
Reader Question:
Report V Codes for Coumadin Therapy
Question: We frequently get patients coming in for a Protime test with a diagnosis of &q... Read more
Reader Question:
West Nile Virus Requires a Nonspecific Code
Question: Our lab has been receiving more orders for the test for West Nile virus. Is th... Read more
Reader Question:
Include Diagnosis for Special Stain Documentation
Question: Must the pathology report include an interpretation for each special stain befor... Read more
You Be the Coder:
PSA Screening Tests
Question: Our lab performs PSA screening tests. I'm familiar with the lab NCD for PSA, and... Read more
Think You're Coding FISH Procedures Correctly? Not if You Aren't Following These Rules
Experts explain tissue versus nontissue guidelines If you've been waiting for dire... Read more
Don't Code FISH for Every HER-2/neu
Method is the key: Not every HER-2/neu test uses fluorescence in situ hybridization (FISH)... Read more
How to Get Paid for Drug Monitoring Tests
We'll tell you how to use 3 new V codes Physicians sometimes order lab tests to mo... Read more
Prepare Your Lab for Fee Schedule Changes
CMS recently previewed new codes and new pricing that may affect your bottom line. Lab g... Read more
Report Each Lung Needle Biopsy
Question: Our pathologist received three vials from transbronchial needle biopsies for a... Read more
Reader Question:
Use 88300 for Gross Only
Question: Suppose the lab accessions a breast biopsy specimen, providing a gross descript... Read more
Reader Question:
Ovary Can Stand Alone
Question: For a 59-year-old patient with a right ovarian mass, the surgeon submitted the ... Read more
You Be the Coder:
Report All Special Stains
Question: Can we bill for special stains when the pathologist states that the stain was "n... Read more
Got Medical Necessity? Look for New ICD-9 Codes in Lab NCDs and LMRPs
Don't get caught with old diagnosis codes that won't get your lab claims paid. ICD-9 2004 ... Read more
ICD-9 Updates Codes for Benign Prostate
With or without urinary obstruction? That is the question. To assign the correct diagnos... Read more
Report Ordering or Final Diagnosis on Medicare Claims?
When should you report the ordering physician's diagnosis, and when should you report the ... Read more
Report Most-Definitive Diagnosis for Physician Pathology Services
If you know the final pathologic diagnosis, put it on your Medicare claim. CMS clarifies... Read more
Reader Question:
Immunofluorescence Studies Include Preparation
Question: Given a renal biopsy for suspected cyclosporine toxicity following cardiac tran... Read more
Reader Question:
Use Specific Code for Tzanck Preparation
Question: How should we report a Tzanck stain for herpes? Should we report it as special ... Read more
Reader Question:
CMS Adds 401.1 to Lipid NCD Medical-Necessity List
Question: Physicians often order lipid testing for patients diagnosed with benign hyperte... Read more
You Be the Coder:
Specimen Not Too Small if You Do the Work
Question: If the pathologist examines frozen sections from a small punch skin biopsy durin... Read more
Think NCCI 9.2 Wont Impact Your Lab?
Medicare Adds Hematology and Consultation Edits If you report hematolo... Read more
Know How to Override NCCI 9.2 Consultation Bundles
If your pathologist performs a consultation on referred material (88321-88325) with a... Read more
2 Ways Medicare Fee Schedule Adjustment Can Save You Money
Good news for pathologists: You wont have to cough up overpayments arising from the delaye... Read more
Want Payment for Diagnostic PSA? Code Symptoms, Not BPH
Medicare has demoted benign prostatic hypertrophy (BPH). Although it was once considered a... Read more
Screening PSA Is Another Story:
You Dont Get Paid Under Diagnostic PSA Rules
Forget everything you just learned about diagnostic PSA coding. If you want to report a sc... Read more
NCD Lists Covered Diagnosis Codes
You can use diagnosis codes for any of the following clinical situations to report a dia... Read more
Reader Question:
Details Dictate Prothrombin Time Payment
Question: A 59-year-old patient is on Coumadin for his cardiac arrhythmia. He came in for ... Read more
Reader Question:
Report Immunohistochemistry Per Specimen, Per Stain
Question: If the pathologist receives two separately identified sentinel lymph nodes and w... Read more
You Be The Coder:
Test Includes Molecular Diagnostics
Question: A physician ordered an HCV RNA PCR test and HCV RNA quantification. In addition ... Read more
3 Steps to Improve Your Neck Specimen Coding Skills
Whatever the otolaryngologist excises, the pathologist examines. But coding these... Read more
Want to Improve Iron-Test Pay? Dont Forget Medical Necessity
Your labs serum iron revenues could be anemic if insurers dont know that the patients di... Read more
Surgical Pathology Neck Specimens:
Get the Level Right
Knowing the organ name is not enough. Although reporting head and neck tissue examination ... Read more
Know Serum Iron Studies
Serum iron tests give different diagnostic information, so not all conditions warrant the ... Read more
No Cervix? Medicare Explains Reporting Pap Smear Screens
At last you can tell the truth when billing Medicare for posthysterectomy screening Pap s... Read more
Reader Question:
Bill for Touch Preps With Sentinel Node
Question: When performing a sentinel lymph node biopsy, our pathologists often perform t... Read more
Reader Question:
Identify Femoral Head Specimen
Question: How should we report the examination of a femoral head submitted for avascular ... Read more
Reader Question:
Assign Placenta Most Specific Diagnosis
Question: When our pathologists examine placentas submitted due to cesarean or other abn... Read more
Reader Question:
Special Stains Not Clear
Question: Is it possible to get a complete list of stains that we should report as eithe... Read more
You Be the Coder:
No Hidden Rules for Fecal-Occult Blood
Question: Would you please clarify when to use G0107 versus 82270 for fecal-occult blood... Read more
Unravel Pathology Consultations Crazy Quilt of Codes
All consultations are not created equal. Even abiding by the three R's (request, repor... Read more
Take the Consultation Challenge Take the Consultation Challenge
It's good to know the rules, but the proof is always in the pudding. Because three dis... Read more
NCCI Enforces Pap-Test Dualism
Medicare says pick one a Pap test is either for screening or for diagnostic purposes.... Read more
READER QUESTION:
Settle Bethesda/ICD-9 Discord
Question: Which diagnosis code should we use to report ASCUS Pap smear results under the... Read more
READER QUESTION:
Panel Code Includes Every Test
Question: Our lab performed the following tests for a patient per physician order: 842... Read more
READER QUESTION:
Report New CLIA-Waived HIV Test
Question: Our lab will begin performing a new test manufactured by OraSure Technologies ... Read more
READER QUESTION:
Multiple Nevi May Be One or More Specimens
Question: When the pathologist receives five nevi in two containers, how should we repor... Read more
READER QUESTION:
Use Modifier -91 for Multiple Glucose Tests
Question: A 15-year-old diabetic patient came to the emergency room complaining of weakn... Read more
You Be the Coder:
Dont Report Certain Thyroid Tests Together
Question: Our lab recently began performing the free T4 thyroid test. Previously, we per... Read more
NCCI 9.1 Puts Method in Its Madness
"A rose by any other name would smell as sweet," acco... Read more
NCCI 9.1 Deletions Offer Micro Relief
Frustrated microbiologists will rejoice to learn that National Correct Coding Ini... Read more
Telepathology Should Be Transparent to Coders
Performing pathology services from afar using telecommunications and compute... Read more
Know the 5-7-9s of Breast Coding
With multiple breast codes and many tissue descriptions, what's a coder to do? You... Read more
Reader Question:
ICD-9 Coding Is an Exact Science
Question: I've been told that when we report ICD-9 diagnosis codes, we have t... Read more
Reader Question:
Cell Block Stands Alone
Question: How should we code for bone marrow aspiration? Our pathologist may or may not ... Read more
Reader Question:
Container Irrelevant for Tonsils and Adenoids
Question: How should we code for tonsils and adenoids submitted under the following th... Read more
Reader Question:
Immunofluorescent Studies Include Slide Prep
Question: When our lab performs immunofluo-rescence microscopy on a kidney biopsy, how s... Read more
Reader Question:
Know Frequency Rules for Hyperlipidemia Testing
Question: If a patient is receiving treatment for hyperlipidemia, how should we code th... Read more
You Be the Coder:
Micro Solution to Definitive Disagreement
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Add Up Specimens to Report Radical Cystectomy
Pathologists aren't the only ones who have to separate tiss... Read more
Medicare Fee Schedule Looking Up
After gloomy predictions of the second straight annual rate cut for Medicare physici... Read more
Use NCD to Clear Up Urine Cultures
Don't lose out when it comes to Medicare's new urine culture guidelines. Medicare's ... Read more
Dont Be Stumped by Clinical Situations
Having a hard time applying the National Coverage Determination (NCD) urine cultur... Read more
Watch Your Whysto Get Paid for Urine Culture
Medicare says "show me a sign" before it will cover bacterial urine cultures. Labs... Read more
Susceptibility Tests Are for Any Source
Finding susceptibility studies in a urine culture National Coverage Determination (NCD... Read more
Coding Clarification for Uterus,Tubes and Ovaries
The February 2003 Pathology/Lab Coding Alert reader question "Uterus and Ov... Read more
Reader Question:
One Stain Gets One Code
Question: Our lab has begun a new protocol for temporal artery biopsies based on resear... Read more
Reader Question:
No Code for Insufficient Volume
Question: We know that for cytopathology specimens, we cannot bill for hemolyzed or ina... Read more
Reader Question:
Date of Service = Date of Collection
Question: Our lab sometimes performs tests a day or more after the specimen was collect... Read more
Reader Question:
Know Units for Referred Material Consultation
Question: Our pathologists occasionally receive slides for interpretation that have bee... Read more
Reader Question:
Koilocytosis Conundrum
Question: The pathologist received a cervical biopsy from a patient with a pre-op diagn... Read more
You Be the Coder:
Cyto-Histo: Correlation or Consultation?
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Reality Check New Pap Codes Reflect Laboratory Practice
"Thin prep" Pap tests are in, but manual screenings are out. So what's a coder to do... Read more
Labs Must Decode Physician Pay Rule
Payment rates are just the tip of the iceberg in the 2003 Physician Fee Sche... Read more
Dilemma Remains for Single-Incision Bone Marrow Sampling
A breakthrough bone marrow code has vanished before our very ey... Read more
Dont Get Stuck With Venipuncture Costs
Blood-draw services can stick it to you unless your lab follows payer covera... Read more
Reader Question:
Use V Codes for Preventive Screening
Question: Which diagnosis code should I use to bill Medicare for preventive ... Read more
Reader Question:
Lymph Nodes to Bundle or Not to Bundle
Question: We bill axillary node dissections and radical neck dissections as 88307. How ... Read more
Reader Question:
Method and Organism Dictate Infectious Agent Codes
Question: Should we bill the Chlamydia and gonorrhea screening in pregnancy using 8749... Read more
Reader Question:
Code Exostosis for Carpal Boss
Question: Our pathologist examined a specimen that appeared to be submitted in fragment... Read more
Reader Question:
Report Consult With Intraoperative Touch Preps
Question: Our pathologists often evaluate frozen sections intraoperatively to provide ... Read more
You Be the Coder:
Know Whats Bundled With Immunofluorescent Tissue Studies
Test your coding knowledge.Determine how you would code this situation before lookin... Read more
CCI Update:
New CPT Codes Are All Bundled Up
CMS was quick to add Correct Coding Initiative (CCI) edit pairs for the new ... Read more
Physician Fee Schedule Conversion a Real Downer
Only an act of U.S. Congress can help now. Medicare's 2003 Physician Fee Schedule c... Read more
11th-Hour Ruling Extends TC Grandfather Exception
Saved by the bell CMS rescued some hospitals and independent labs from technical comp... Read more
Medicare Payment Change How Will You Fare?
If you do lots of fine needle aspiration (FNA) surgical procedures, Pap interpretations, ... Read more
Reader Question:
Uterus and Ovaries to Bundle or Not to Bundle
Question: The pathologist performs frozen sections and a surgical pathology exam of rig... Read more
Reader Question:
Pap Interpretation If You Did It, Code It
Question: How should we report the pathologist's service if a cytotechnologist identifi... Read more
Reader Question:
And the PSA Diagnosis Is ...the Reason for the Test
Question: How should we report a prostate specific antigen (PSA) test for a 57-year-ol... Read more
Reader Question:
Code Specific Fecal WBC
Question: What is the correct code for a stool white blood cells (WBC) test? Physicians ... Read more
Reader Question:
STD Test Exposure or Worry Is Diagnosis Key
Question: If an asymptomatic patient reports a concern that she might have a sexually tr... Read more
You Be the Coder:
Cytology Concentration and Stains Confound Coders
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Source Is Key to Stem-Cell Harvesting Codes
Stem-Cell Codes Add Up to Accurate Reimbursement "New and improved&quo... Read more
CPT 2003 Infuses Lifeblood Into Apheresis Codes
Outdated CPT descriptors kept coders scratching their heads when reporting aphere... Read more
Modify Confusion Learn When to Use -91 and -59
When a payer assumes that you've either unbundled or duplicate-billed, modifier -59 (Disti... Read more
Same CPT Code for Different Tests:
Same CPT Code for Different Tests:
Should Labs Use Modifier -91,-59 or None at All? What's a coder to do w... Read more
Reader Question:
Differentiate Physician-Office Lab Urine Tests
Question: Which code should our physician-office lab use to report urine tests that we ... Read more
Reader Question:
Weigh in on New Hysterectomy Codes
Question: Will the new surgery codes for myomectomy and hysterectomy (58146, 58545-5855... Read more
Reader Question:
And/OrDictates Influenza A/B Test Code
Question: Our lab carries out an influenza A/B test using a commercial kit called Zstat... Read more
Reader Question:
Breast Sampling Method Controls Code
Question: Should we code the interpretation of a breast fine-needle aspirate (FNA) diff... Read more
Reader Question:
Ask Medicare for Bilateral Bone Marrow Correction
Question: We sometimes perform bone marrow aspirations or biopsies bilaterally, one each... Read more
You Be the Coder:
Stationary/Mobile Phase Determines Drug Screen Coding
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Available Years:  2003  2002  2001  2000