Pathology/Lab Coding Alert

4 Tips Improve Your 88342 Billing
Don't lose $90 for each additional antibodyWhen your lab uses an immunohistochemistry cock... Read more
Reporting Injection With FNA, Bone Marrow? Not Anymore
Aspirations and needle core include 'stick' codes When a pathologist acquires... Read more
News Brief:
Use Special Modifier for Disaster-Related Claims
You can use the new code regardless of where you're located Don’t let your ... Read more
Avoid 'Gross-Only' Pitfalls for Pathologists' Assistants
Billing a physician service?  That could be fraudBecause a pathologists' assistant ro... Read more
Billing Corner:
Don't Ignore Incident-to Rules or You Could Harm Your Bottom Line
Hint: The key is recognition and supervisionIf the term "incident-to" leaves you perp... Read more
READER QUESTIONS:
Don't Misplace Modifier 59
Question: I know that I can use modifier59 to unbundle codes under the right circumstances... Read more
READER QUESTIONS:
Consultation Date of Service Differs
Question: What is the correct date of service when our pathologist performs a second-opini... Read more
READER QUESTIONS:
Look for Anaerobic Culture Exception
Question: How should we code the presumptive identification of anaerobic and aerobic organ... Read more
READER QUESTIONS:
Code for Comparable Specimen
Question: What code should we use for the pathology exam of the following specimen: "ethmo... Read more
You Be the Coder:
Code Steps for Hepatitis C?
Question: When our lab identifies the Hepatitis C genotype, should we separately report ... Read more
Focus on Cytopathology Bundling Rules--We'll Show You When to Override Edits
Don't bill separately for 88184-88189 cell reviewIf you're billing separately for a cytolo... Read more
Get More for Flow Cytometry Technical Services
Medicare fee schedule raises 88184-88185 payment by at least 22 percent After cutting... Read more
Truncated Diagnosis Could Cost You $49.04
Add the key fifth digit for 287.3 Expecting to get paid for HIV or other lab tests fo... Read more
Think You Can Code Mohs for Separate Excision and Exam?
Number of physicians should determine your code choiceA pathologist diagnoses a cancerous ... Read more
READER QUESTIONS:
Not All Shots Are Vaccinations
Question: We are trying to link the purified protein derivative (PPD) tuberculosis test ... Read more
READER QUESTIONS:
Use Caution With Referral Arrangements
Question: As in independent laboratory, can we charge for blood draws made by our phleboto... Read more
READER QUESTIONS:
Coding Repeat Blood Counts? Read This First
Question: Sometimes, the transplant/stem cell physicians at our hospital send us two sampl... Read more
READER QUESTIONS:
Thyroid Tests Call for Medical Necessity
Question: We frequently receive denials for thyroid function tests, especially TSH. Why do... Read more
READER QUESTIONS:
Save Modifier 90 for Independent Labs
Question: What are the restrictions on using modifier 90 for billing referred lab tests?Te... Read more
You Be the Coder:
Watch Out for Sequential Procedures
Question: Our pathologist extracted a fine-needle aspiration specimen from a breast lesi... Read more
Zero In on Breast Specimens With Your New Best Coding Tool
Don't miss the 88305/88307 distinction Some breast coding is easy - but there'... Read more
Test Your 88305/88307 Breast Coding Savvy
Don't code undocumented marginsTry your hand at coding breast-lesion excisions using the p... Read more
Watch for 3 Complications When Coding Special Stains
Don't get tripped up on stain name Each time you choose between 88312 and 88313, ... Read more
Say Goodbye to 88313 With Fecal Ova and Parasites
Check out CPT 2006 microbiology stain codeStill confused about how to report a trichrome s... Read more
Biopsy or Excision? Difference Explained in Coding Terms
Know the surgeons' language to decode breast tissue Here's a surprise: Understanding surg... Read more
READER QUESTIONS:
Unbundled With NCCI Modifier Indicators
Question: In the National Correct Coding Initiative (NCCI) edits, what do the modifier i... Read more
READER QUESTIONS:
For Unsatisfactory Smear, Use 795.08
Question: Which diagnosis should I use for a Pap smear ordered due to a prior unsatisfacto... Read more
READER QUESTIONS:
Learn to Code Flow Cytometry's Multiple Markers
Question: Our pathologist performs a flow cytometry cancer study looking at CD45, CD34 and... Read more
READER QUESTIONS:
Cell Storage Stands Alone
Question: Our Medicare payer tells us that we cannot bill for 88184 with G0265 when our l... Read more
You Be the Coder:
Avoid Microbiology Trichrome Dilemma
Question: When our pathologist examines a trichrome stain on a fecal smear for ova and p... Read more
Unbundling More Extensive Procedures NCCI Says Think Again
You can't override '0' modifier indicator Watch out for new edit pairs yo... Read more
Sneak a Peek at New Laboratory Codes for 2006
    Prepare for lipoprotein and molecular diagnostics code changes ... Read more
Prepare to Change How Your Lab Reports TB Assay
New blood-test code 8648x changes how you manage TB testing A new test for tuberculos... Read more
Forget These Screening Codes?
Forget payment from CMSV codes play a vital role in Medicare's screening services - and fa... Read more
Stop Losing Cash Over V Code Myths
V codes can document the need for a test Don't shun V codes because you believe s... Read more
READER QUESTIONS:
Margins Define Breast Specimen
Question: When our pathologist receives a breast lesion, the surgeon sometimes identifies ... Read more
READER QUESTIONS:
Watch Out for Identical-Claim Edit
Question: We're a reference lab, and we've recently gotten a few Medicare denials with a m... Read more
READER QUESTIONS:
Use a Modifier for a Repeat Test
Question: A physician ordered two glucose tests in one day based on a patient's diagnosis ... Read more
READER QUESTIONS:
More Specific Code Reports Cross Match
Question: When our pathologist consults on a blood cross match, should we report a clinica... Read more
READER QUESTIONS:
Only Special Stains Are Separate
Question: Please help with coding for the following scenario: three slides from pelvic was... Read more
You Be the Coder:
Know Your Epididymis Codes
Question: What are the correct diagnosis and procedure codes for the following specimen: R... Read more
Using 20220 When Pathologist Takes Bone-Marrow Biopsy? Think Again
Here's how to avoid this coding red flag Yes, you have to use a CPT surgery code when your... Read more
3 Modifiers Tell the Tale of ABN Status
Get Medicare to tell patients they must pay When you tell a patient he'll have to pay for... Read more
Noncovered Lab Tests Don't Have to Mean Lost Revenue
Use ABNs to encourage patient payment Just because an ordered lab test isn't covered does... Read more
'History of' and Genetic V Codes Show Medical Necessity
Use ICD-9 changes to confirm reason for lab tests If you're looking for a better way to s... Read more
Reader Questions:
Differentiate Screening and Diagnostic Codes
Question: When coding for a lab test, does it matter if the physician ordered the test for... Read more
Reader Questions:
V Codes Clarify Genetic Susceptibility
Question: Tennessee Subscriber Answer: Don't report the condition as if... Read more
Reader Questions:
Each Specimen Requires 88331
Question: How should I code a pathology report that lists frozen section exam from a breas... Read more
Reader Questions:
Diagnose Insulin Use in Diabetes
Question: A physician orders repeated blood glucose tests for a patient diagnosed with typ... Read more
You Be the Coder:
Must Pathology Consultation Stand Alone?
Question: When our pathologist is called into surgery for immediate diagnosis of a breast ... Read more
Tell the Whole Story With Genetic-Testing Code Modifiers
2-character modifier just might get you paid You may not be using them yet, but CPT... Read more
Clip-and-Save Chart:
Cross-Reference Your Lab Tests to CPT 2005 Genetic-Test Modifiers
Post this chart in your lab for easy reference to the new genetic-testing code modifiers... Read more
Don't Miss Payment for New Electrophoresis Codes
Look for pro-fee denials with non-serum sources You've always billed for your pathologis... Read more
Improve 'Second Chance' for Claims Denials
Prepare now for quicker appeals turnaround Now's the time to streamline your lab&#... Read more
Reader Questions:
Bone Marrow Depends on Site
Question: The pathologist examined a bone marrow biopsy from the left iliac crest and a bo... Read more
Reader Questions:
Check NCD for Denial Clues
Question: Our lab frequently faces denials on thyroid function test claims. Why does this ... Read more
Reader Questions:
Know Local Coverage Rules
Question: I've heard that an LCD can help us avoid denials on laboratory diagnostic tests.... Read more
You Be the Coder:
Does Records Review Make Consultation?
Question: Our pathologists always review patient records when they examine a bone-marrow o... Read more
Avoid These 3 Pitfalls to Improve Your ICD-9 Skills
 Make sure to code the most specific diagnosis You have to know when you should ... Read more
Quick Quiz:
Test Your Diagnosis Coding Savvy
Use these clinical examples to sharpen your skills You're faced with an outpatient patholo... Read more
Touch Preps Hit With Tough NCCI Edit
You can't override new cytopathology or thyroid bundles Watch out for two new National Co... Read more
5 Tips for Flawless Neoplasm Diagnosis Coding
 Know the ICD-9 table and terminology to get the code right When the pathologist... Read more
Decipher Malignant, In Situ and Uncertain
Use this primer to zero in on neoplasm type  If you wonder what "behavior&q... Read more
Reader Questions:
Concentration Changes Sputum Code
Question: Our pathologist sometimes examines a sputum cytology cytospin and cell block. We... Read more
Reader Questions:
Use Current Codes and Date for Archives
Question: A physician recently sent a breast tissue specimen to our pathologist for a HER-... Read more
Reader Questions:
Choose 1 Test for Diabetes Screening
Question: Physicians often order a fasting glucose (CPT 82947 ), followed two hours later ... Read more
You Be the Coder:
Use Listed Specimen for Surgical Pathology
Question: Our pathologist examined a colon resection for tumor and diagnosed metastatic ov... Read more
Choose the Right Flow Cytometry Codes in 6 Easy Steps - Here's How
You can't count on 'per marker' coding for flow cytometry anymore After eliminating 8818... Read more
Quick Quiz:
Get a Grip on Flow Cytometry Changes for 2005
3 scenarios put your cancer immunophenotyping coding knowledge to the test Still tryi... Read more
Use 86586 for Unspecified Immunology Counts
Don't report flow cytometry for clinical lab tests You'll need to learn a new way to use "... Read more
Make Sure You Get Paid for Pre-Diabetes Screening
Modifier -TS ups the frequency ante You've been performing glucose tests to screen at-ris... Read more
Medicare Screens All Patients With Diabetes Risk
But pre-diabetes means more frequent testing  Medicare's annual screening coverage a... Read more
Reader Questions:
Document Collection Date for Billing
Question: For blood tests, should our lab report the date of service as the day of the blo... Read more
Reader Questions:
Diagnosis Is Key for Lipid Tests
Question: Our lab performs regular lipid testing for patients with disorders such as hyper... Read more
Reader Questions:
Don't Unbundle Cytology Smears
Question: When the cytotechnologist prepares cerebrospinal fluid for evaluation, we someti... Read more
You Be the Coder:
Add Up Unique Lab Panel Codes
Question: When a physician orders an evocative/ suppression panel for hormones, the grou... Read more
Use These 4 Tips for Reporting New and Revised IHC Codes
Lab method and results determine your code selection CPT 2005 changes the way you report t... Read more
Be Sure You Reserve 88342 for Qualitative IHC
Counting cells earns semiquantitative payDon't be confused by reports that IHC grading sys... Read more
Here's How to Get Paid for Bone Marrow Biopsy and Aspiration
Maneuver coding restrictions with modifier and G code If you're reporting a bone... Read more
Put Another V Code on Your Pap Screening List
CMS expands payable diagnosesYou can look forward to getting paid for screening Pap smears... Read more
READER QUESTIONS:
Know -TC Grandfather Exception Rules
Question: Has the "grandfather exception" expired, which allows independent labs to bill M... Read more
READER QUESTIONS:
Use E/M Cautiously for Test Encounters
Question: We operate a physician-office lab that monitors coumadin levels in patients on a... Read more
READER QUESTIONS:
ICD-9 Help Abounds
Question: Because physicians can order lab tests with a narrative diagnosis, we sometimes ... Read more
READER QUESTIONS:
Don't Confuse Screening and Diagnostic FOBT
Question: Which codes does Medicare cover for the screening fecal-occult blood test?Colora... Read more
You Be the Coder:
Watch Out for Modifier Indicator
Question: A physician sent two specimens from a single patient to our lab: a Pap smear, an... Read more
Update Your ISH/FISH Coding - Here's How
CPT Codes 2005 expands 88365-88368 CPT 2005 erased the line in the sand - you should ... Read more
Test Your ISH Coding Skills
Try coding the following scenarios, then see what our expert saysExample 1: A pathologist ... Read more
Classify ISH Test as an Adjunct Service
Surgical/cytology service versus clinical cytogenetics distinguishes codes With two s... Read more
NCCI 11.0 Limits Use of New CPT 2005 Codes
Don't report flow cytometry with immunology, cytopathology If you want to code 20... Read more
Separate Infusion/Injection Billing Won't Do
Beware of NCCI 'G' code bundles Medicare created new HCPCS Level II codes for... Read more
READER QUESTIONS:
Watch for New PAPP-A Code
Question: What is the correct way to bill for a pregnancy-associated plasma protein-A (PAP... Read more
READER QUESTIONS:
Drop G0001 for Medicare Venipuncture
Question: Can the lab bill for blood collection? Which code should we use?Ohio SubscriberA... Read more
You Be the Coder:
Specify Diagnosis With External-Causes Codes
Question: The lab received an order for an HIV test as part of a workers' compensati... Read more
Scrutinize Diagnoses Before You Bill Screening Tests
"V" codes show medical necessity for diabetes, heart disease Now your lab can get paid fo... Read more
Get Screening Test Frequency Right - or Get an ABN
Don't forget to add -GAYou can't exceed Medicare's frequency limitations for diabetes or c... Read more
2005 Medicare Payments - How Will Your Lab Fare?
You'll see little growth to pathologists' fees The big winners on Medicare's 2005 Physic... Read more
Follow These 3 Steps to Report a Non-Diagnostic Specimen Exam
Document work, specimen description to assign proper 88300-88309 Just because your pathol... Read more
Quick Quiz:
Test Your "Inadequate Specimen" Coding Savvy
Use these clinical examples to sharpen your skillsYou're faced with a pathology report tha... Read more
Reader Questions:
Specimen Is Frozen Section Unit of Service
Question: How should we use the frozen section codes for the following situation: The path... Read more
Reader Questions:
Same Organism Tests Are Mutually Exclusive
Question: If the lab performs a hepatitis C qualitative PCR and an HCV RNA quantification ... Read more
Reader Questions:
Newly-Stained Slides Warrant Code
Question: When our pathologist receives a tissue block with a request for consultation, he... Read more
You Be the Coder:
Choose One Procedure for Cytopathology Specimen
Question: Is it ever appropriate to separately bill two cytopathology methodologies for th... Read more
CPT 2005:
Here's How to Use the New B, NK and Stem Cell Codes
They're not for hematolymphoid phenotyping CPT 2005 adds three new immunology codes for c... Read more
Coding Basics:
Choose the Right Modifier for Repeat or Bundled Tests
-59 or -91 tells the whole story If your lab performs the same test twice or performs ... Read more
Stay on OIG's Good Side - Use Modifier -59 Wisely
Don't report similar tests for one specimenWhen you bypass National Correct Coding Initiat... Read more
Keep Up With the 2005 CPT Code Changes
Here it is, all in one place - a complete list of about 40 code additions, deletions, revi... Read more
Reader Questions:
Identify Drug-Resistant Infections
Question: Our lab is seeing a rise in cultures that identify penicillin-resistant staph in... Read more
Reader Questions:
Report Ordering and Final Diagnosis for Paps
Question: Our lab performs high-risk HPV DNA testing for every Pap smear that has a result... Read more
You Be the Coder:
Electrophoresis - Here Are the 2005 Changes
Question: I am billing the professional side only for the following tests: serum protein e... Read more
Available Years:  2005  2004  2003  2002  2001  2000