Pathology/Lab Coding Alert
CPT® 2020:
Isolate New Codes for Microbiology Analyses
Don't miss relevant PLA additions. Microbiology labs have just one new Category I code fo... Read more
Isolate New Codes for Microbiology Analyses
Don't miss relevant PLA additions. Microbiology labs have just one new Category I code fo... Read more
Category III Update:
Chemo-Screening Test Earns CPT® 2020 Code
Deleted 0357T leads to unlisted code. Among CPT® changes that lab coders might fail to n... Read more
Chemo-Screening Test Earns CPT® 2020 Code
Deleted 0357T leads to unlisted code. Among CPT® changes that lab coders might fail to n... Read more
Compliance:
Get Ready for Stricter Medicare Provider Enrollment Rules
New instruction may limit participation. Don't let “patients over paperwork” lull you... Read more
Get Ready for Stricter Medicare Provider Enrollment Rules
New instruction may limit participation. Don't let “patients over paperwork” lull you... Read more
Reader Question:
Identify Esophageal Section
Question: What is the correct diagnosis code for a malignant lesion in the “abdominal es... Read more
Identify Esophageal Section
Question: What is the correct diagnosis code for a malignant lesion in the “abdominal es... Read more
Reader Question:
Use Encryption to Protect ePHI
Question: How can we make sure encryption is part of our HIPAA compliance? Codify Subscri... Read more
Use Encryption to Protect ePHI
Question: How can we make sure encryption is part of our HIPAA compliance? Codify Subscri... Read more
Reader Question:
Add Fecal Specimen to H. Pylori Test
Question: Can we bill the H. pylori detection and antibiotic resistance panel from America... Read more
Add Fecal Specimen to H. Pylori Test
Question: Can we bill the H. pylori detection and antibiotic resistance panel from America... Read more
Reader Question:
Choose 83500 for Activity
Question: We performed an antithrombin III activity assay for a patient taking heparin. Ho... Read more
Choose 83500 for Activity
Question: We performed an antithrombin III activity assay for a patient taking heparin. Ho... Read more
Reader Question:
Find Breast History Without Final Dx
Question: The pathologist examines a lumpectomy specimen in which the op note states that ... Read more
Find Breast History Without Final Dx
Question: The pathologist examines a lumpectomy specimen in which the op note states that ... Read more
You Be the Coder:
Capture Each Microbiology Step
Question: A physician performed incision and drainage of a subareolar breast abscess and s... Read more
Capture Each Microbiology Step
Question: A physician performed incision and drainage of a subareolar breast abscess and s... Read more
CPT® 2020:
Don't Miss Therapeutic Drug Assay Update
Distinguish presumptive, definitive, therapeutic testing. You'll have six new codes to us... Read more
Don't Miss Therapeutic Drug Assay Update
Distinguish presumptive, definitive, therapeutic testing. You'll have six new codes to us... Read more
CPT® 2020:
Recognize PLA Drug Test Codes
You might need to pre-empt Category I. There's a catch for all the drug-test coding advic... Read more
Recognize PLA Drug Test Codes
You might need to pre-empt Category I. There's a catch for all the drug-test coding advic... Read more
Case Study:
Find Polyp Dx in Screening Colonoscopy
Focus procedure code, too. Specimens from colonoscopy procedures are common fare for path... Read more
Find Polyp Dx in Screening Colonoscopy
Focus procedure code, too. Specimens from colonoscopy procedures are common fare for path... Read more
QPP:
Look for MIPS Policy Changes for 2020
See what streamlined MVP may bring. With an update to the Quality Payment Program (QPP) o... Read more
Look for MIPS Policy Changes for 2020
See what streamlined MVP may bring. With an update to the Quality Payment Program (QPP) o... Read more
Reader Question:
Specify Procedure and Reason for Aspergillus Test
Question: Our lab performed an EIA test for Aspergillus antigen detection, but we received... Read more
Specify Procedure and Reason for Aspergillus Test
Question: Our lab performed an EIA test for Aspergillus antigen detection, but we received... Read more
Reader Question:
Share Data With HIPAA Compliance
Question: I heard there's a new rule about sharing data under HIPAA. Is that true, and if ... Read more
Share Data With HIPAA Compliance
Question: I heard there's a new rule about sharing data under HIPAA. Is that true, and if ... Read more
You Be the Coder:
Distinguish Blood Draw Codes
Question: What is the difference in the venipuncture codes 36400-36410, 36420-36425, and 3... Read more
Distinguish Blood Draw Codes
Question: What is the difference in the venipuncture codes 36400-36410, 36420-36425, and 3... Read more
Clinical Lab:
Master PSA Test Claims in 4 Steps
Grasp code and compliance tips. If your lab runs plenty of prostate specific antigen (PSA... Read more
Master PSA Test Claims in 4 Steps
Grasp code and compliance tips. If your lab runs plenty of prostate specific antigen (PSA... Read more
ICD-10-CM:
Fortify Diagnosis Coding With 3 Q/A Scenarios
Grasp your lab's contribution to final Dx. Whether your clinical lab receives a narrative... Read more
Fortify Diagnosis Coding With 3 Q/A Scenarios
Grasp your lab's contribution to final Dx. Whether your clinical lab receives a narrative... Read more
Medicare:
You're Not Immune to Fraud and Abuse Charges
Some coding practices could trap you. If you're holier-than-thou about healthcare provide... Read more
You're Not Immune to Fraud and Abuse Charges
Some coding practices could trap you. If you're holier-than-thou about healthcare provide... Read more
Reader Question:
Take These Tick-Bite Tips
Question: When a patient has a tick bite and the clinician orders a test for suspected Lym... Read more
Take These Tick-Bite Tips
Question: When a patient has a tick bite and the clinician orders a test for suspected Lym... Read more
Reader Question:
Distinguish Clinical Panel Test from Panel Code
Question: Our lab performs the obstetrics panel, but we use the automated treponemal antib... Read more
Distinguish Clinical Panel Test from Panel Code
Question: Our lab performs the obstetrics panel, but we use the automated treponemal antib... Read more
You Be the Coder:
Capture Each Bone Marrow Biopsy Step
Question: Our pathologist examined an iliac crest bone marrow biopsy following decalcifica... Read more
Capture Each Bone Marrow Biopsy Step
Question: Our pathologist examined an iliac crest bone marrow biopsy following decalcifica... Read more
CPT® 2019 Lab Preview:
Look for New PLA, Molecular Pathology, and Chemistry Codes
Expect MAAA and microbiology changes, too. We have the scoop on new 2020 clinical laborat... Read more
Look for New PLA, Molecular Pathology, and Chemistry Codes
Expect MAAA and microbiology changes, too. We have the scoop on new 2020 clinical laborat... Read more
ICD-10-CM:
Prepare for Lab-Relevant 2020 Diagnosis Codes
Start using new and revised codes Oct. 1, 2019. With 273 additions, 21 deletions, and 30 ... Read more
Prepare for Lab-Relevant 2020 Diagnosis Codes
Start using new and revised codes Oct. 1, 2019. With 273 additions, 21 deletions, and 30 ... Read more
Medical Record:
Master Documentation Tips and Pitfalls
Use cut and paste judiciously. You may love the timesaving features of electronic health ... Read more
Master Documentation Tips and Pitfalls
Use cut and paste judiciously. You may love the timesaving features of electronic health ... Read more
Reader Question:
Zero in on FNA Unit of Service
Question: How should I code the procedure when our pathologist extracts an FNA of lef... Read more
Zero in on FNA Unit of Service
Question: How should I code the procedure when our pathologist extracts an FNA of lef... Read more
Reader Question:
Report Final Diagnosis
Question: Our pathologist received a biopsy of a single pulmonary nodule from the pat... Read more
Report Final Diagnosis
Question: Our pathologist received a biopsy of a single pulmonary nodule from the pat... Read more
You Be the Coder:
Focus Liver and Lymph Node Coding
Question: We have a case that the pathology report identifies as a “right hepatic w... Read more
Focus Liver and Lymph Node Coding
Question: We have a case that the pathology report identifies as a “right hepatic w... Read more
Dermatopathology:
Discover Mohs Openings for Pathology Services
Steer clear of 17311-+17315. Mohs micrographic surgery might result in billable pathology... Read more
Discover Mohs Openings for Pathology Services
Steer clear of 17311-+17315. Mohs micrographic surgery might result in billable pathology... Read more
Coverage:
Master ABN Strategy With This 81551 Case
Beware LCD restrictions or lose pay. Sometimes the only card you hold to get paid for an ... Read more
Master ABN Strategy With This 81551 Case
Beware LCD restrictions or lose pay. Sometimes the only card you hold to get paid for an ... Read more
HIPAA:
Play Taps for Phase 2 of the Audit Program
Don't expect more onsite visits. Three years after the kickoff of Phase 2 desktop audits,... Read more
Play Taps for Phase 2 of the Audit Program
Don't expect more onsite visits. Three years after the kickoff of Phase 2 desktop audits,... Read more
Reader Question:
See What HIPAA Compliance Claims Really Promise
Question: Our office purchased encryption software that claims to be “100-percent HIPAA ... Read more
See What HIPAA Compliance Claims Really Promise
Question: Our office purchased encryption software that claims to be “100-percent HIPAA ... Read more
Reader Question:
Look for Password Relief
Question: Our IT consultant suggests that we update passwords every 30 days, but this is m... Read more
Look for Password Relief
Question: Our IT consultant suggests that we update passwords every 30 days, but this is m... Read more
Reader Question:
Gather Testicle Specimen Info
Question: The pathologist performed an exam of a testicle removed for testicular torsion. ... Read more
Gather Testicle Specimen Info
Question: The pathologist performed an exam of a testicle removed for testicular torsion. ... Read more
You Be the Coder:
Check Out 'Lymphoma Workup' Rules
Question: I've heard that we can charge 88307 instead of 88305 when our pathologist evalua... Read more
Check Out 'Lymphoma Workup' Rules
Question: I've heard that we can charge 88307 instead of 88305 when our pathologist evalua... Read more
Nucleic Acid Probes:
Tripped Up by Too Many ISH Codes? Read This
Distinguish anatomic and clinical tests. If you want to unscramble the four code families... Read more
Tripped Up by Too Many ISH Codes? Read This
Distinguish anatomic and clinical tests. If you want to unscramble the four code families... Read more
Physician Service:
Focus ISH Professional Interpretation Billing
Distinguish TC, 26 modifier use. Now that you've read about the different code families f... Read more
Focus ISH Professional Interpretation Billing
Distinguish TC, 26 modifier use. Now that you've read about the different code families f... Read more
PT/INR:
Check Out 2 Coumadin Coverage Rules
Don't miss management pay. With the need to oversee coagulation in approximately 20 milli... Read more
Check Out 2 Coumadin Coverage Rules
Don't miss management pay. With the need to oversee coagulation in approximately 20 milli... Read more
Audit Proof:
7 Tips Safeguard Your MIPS Data
Secure documentation for six years. If you're involved in Merit-Based Incentive Payment S... Read more
7 Tips Safeguard Your MIPS Data
Secure documentation for six years. If you're involved in Merit-Based Incentive Payment S... Read more
Reader Question:
Identify Lipoma for Code Selection
Question: The op note states that the surgeon performed a herniorrhaphy and that the submi... Read more
Identify Lipoma for Code Selection
Question: The op note states that the surgeon performed a herniorrhaphy and that the submi... Read more
Reader Question:
Go to Drug Screen Codes
Question: When our lab tests a blood specimen for several possible drugs of abuse such as ... Read more
Go to Drug Screen Codes
Question: When our lab tests a blood specimen for several possible drugs of abuse such as ... Read more
You Be the Coder:
Check Out Twin Placenta Scenario
Question: If we receive a twin placenta in two separate containers can we charge 88307 x 2... Read more
Check Out Twin Placenta Scenario
Question: If we receive a twin placenta in two separate containers can we charge 88307 x 2... Read more
Anatomic Pathology:
4 Steps Spotlight Whipple-Case Coding
Don't miss bundling restrictions. When your pathologist evaluates a surgical Whipple rese... Read more
4 Steps Spotlight Whipple-Case Coding
Don't miss bundling restrictions. When your pathologist evaluates a surgical Whipple rese... Read more
Molecular Studies:
Q&A Strengthens Genetic-Testing Know How
Look for coverage opportunities. More and more labs are offering genetic tests to aid phy... Read more
Q&A Strengthens Genetic-Testing Know How
Look for coverage opportunities. More and more labs are offering genetic tests to aid phy... Read more
ICD-10-CM Basics:
Decipher Excludes1 Notes For Correct Dx Coding
Let the latest Coding Clinic provide direction. When you spy the Excludes1 note under an ... Read more
Decipher Excludes1 Notes For Correct Dx Coding
Let the latest Coding Clinic provide direction. When you spy the Excludes1 note under an ... Read more
Reader Question:
Choose ICD-10 From Pathology Final Dx
Question: Our pathologist received a bladder specimen described in the op report as “an ... Read more
Choose ICD-10 From Pathology Final Dx
Question: Our pathologist received a bladder specimen described in the op report as “an ... Read more
Reader Question:
Get Your CMS Info in Podcast Form
Question: I heard CMS now has a podcast to update policy information. Is that true, and if... Read more
Get Your CMS Info in Podcast Form
Question: I heard CMS now has a podcast to update policy information. Is that true, and if... Read more
You Be the Coder:
Select Best Glucose Tolerance Test Code(s)
Question: How should we bill a glucose 2 hour test — we tested the patient's fasting glu... Read more
Select Best Glucose Tolerance Test Code(s)
Question: How should we bill a glucose 2 hour test — we tested the patient's fasting glu... Read more
Prostate Biopsy:
Capture Accurate IHC-Stain Pay for G0416 Cases
88344 is still ‘per specimen.' You have only one code choice for Medicare beneficiary p... Read more
Capture Accurate IHC-Stain Pay for G0416 Cases
88344 is still ‘per specimen.' You have only one code choice for Medicare beneficiary p... Read more
Medicare Policy:
Review Your AP-Pro-Fee DOS Practices
Specimen-collection date may be wrong. When you bill the professional component of anatom... Read more
Review Your AP-Pro-Fee DOS Practices
Specimen-collection date may be wrong. When you bill the professional component of anatom... Read more
OIG Report:
Ramp Up for CMS's Audit Focus
Emphasize 4 areas to beat the odds. The HHS Office of Inspector General (OIG) recently pu... Read more
Ramp Up for CMS's Audit Focus
Emphasize 4 areas to beat the odds. The HHS Office of Inspector General (OIG) recently pu... Read more
Reader Questions:
Grasp Reasons for 88141
Question: What type of diagnosis is acceptable to bill a pathologist's review of an a... Read more
Grasp Reasons for 88141
Question: What type of diagnosis is acceptable to bill a pathologist's review of an a... Read more
Reader Questions:
More on 87804
Question: You stated in last month's newsletter that the lab should not report two un... Read more
More on 87804
Question: You stated in last month's newsletter that the lab should not report two un... Read more
Reader Questions:
Make Sure Pay-Back is Timely
Question: Our lab performed an internal audit and determined that we have received so... Read more
Make Sure Pay-Back is Timely
Question: Our lab performed an internal audit and determined that we have received so... Read more
You Be the Coder:
Manage Vitamin D Coding
Question: The lab receives an order for serum levels of vitamin D2 and D3. What are the co... Read more
Manage Vitamin D Coding
Question: The lab receives an order for serum levels of vitamin D2 and D3. What are the co... Read more
Influenza 2019:
Master Lab Codes for Flu Tests With These 3 Tips
Don't miss separate codes for types. Flu season isn't over and may be peaking late, accor... Read more
Master Lab Codes for Flu Tests With These 3 Tips
Don't miss separate codes for types. Flu season isn't over and may be peaking late, accor... Read more
Case Study:
Focus GI Specimen and Diagnosis Codes
Skip reporting pre-op diagnosis. When your pathologist examines and diagnoses multiple GI... Read more
Focus GI Specimen and Diagnosis Codes
Skip reporting pre-op diagnosis. When your pathologist examines and diagnoses multiple GI... Read more
ACOs:
Prepare Your Lab for MSSP Rule Changes
Balance risk/reward for savings payoff. If your lab is part of an Accountable Care Organi... Read more
Prepare Your Lab for MSSP Rule Changes
Balance risk/reward for savings payoff. If your lab is part of an Accountable Care Organi... Read more
Reader Question:
Bundle Tubes With Uterus
Question: Our pathologists are receiving more routine hysterectomies with bilateral fallop... Read more
Bundle Tubes With Uterus
Question: Our pathologists are receiving more routine hysterectomies with bilateral fallop... Read more
Reader Question:
Use Appropriate ABN Modifier
Question: We have an ABN notice for a patient's Pap test because the physician ordere... Read more
Use Appropriate ABN Modifier
Question: We have an ABN notice for a patient's Pap test because the physician ordere... Read more
Reader Question:
Understand LCD/ICD-10 Connection
Question: I heard that Medicare is changing LCDs to eliminate ICD-10 codes. Does that mean... Read more
Understand LCD/ICD-10 Connection
Question: I heard that Medicare is changing LCDs to eliminate ICD-10 codes. Does that mean... Read more
Reader Question:
Pinpoint Vaginal Smear Procedure
Question: A clinician submitted a vaginal smear for a patient experiencing discharge ... Read more
Pinpoint Vaginal Smear Procedure
Question: A clinician submitted a vaginal smear for a patient experiencing discharge ... Read more
You Be the Coder:
Assign Pathology Final Diagnosis
Question: Our pathologist examined a skin lesion of the patient's right ear submitted... Read more
Assign Pathology Final Diagnosis
Question: Our pathologist examined a skin lesion of the patient's right ear submitted... Read more
CCI Update:
Don't Let New Lab Bundles Compromise Your Pay
CPT® 2019 codes top restriction list. The massive Correct Coding Initiative (CCI) versio... Read more
Don't Let New Lab Bundles Compromise Your Pay
CPT® 2019 codes top restriction list. The massive Correct Coding Initiative (CCI) versio... Read more
CPT® 2019:
Broaden HCV Patient Testing With 81596
Grasp guidelines for new liver-disease MAAA code. Your lab's hepatitis C virus (HCV) test... Read more
Broaden HCV Patient Testing With 81596
Grasp guidelines for new liver-disease MAAA code. Your lab's hepatitis C virus (HCV) test... Read more
Compliance:
Assimilate New HHS Cybersecurity Guidance
Streamline methods for your lab's needs. Electronic health records (EHR) and other inform... Read more
Assimilate New HHS Cybersecurity Guidance
Streamline methods for your lab's needs. Electronic health records (EHR) and other inform... Read more
Reader Question:
Capture CF Procreative Testing
Question: Our lab performs testing for genetic carrier status for cystic fibrosis in... Read more
Capture CF Procreative Testing
Question: Our lab performs testing for genetic carrier status for cystic fibrosis in... Read more
Reader Question:
Detail Genes for Colon Cancer Test
Question: Our lab performed a Buccal Colaris genetic test for a patient based on a family ... Read more
Detail Genes for Colon Cancer Test
Question: Our lab performed a Buccal Colaris genetic test for a patient based on a family ... Read more
You Be the Coder:
Master Intraoperative Frozens and Touch-Prep Coding
Question: Our pathologist evaluated a colon resection during surgery by performing frozen ... Read more
Master Intraoperative Frozens and Touch-Prep Coding
Question: Our pathologist evaluated a colon resection during surgery by performing frozen ... Read more
2019 Medicare Pay:
Grasp Final Rule Impact for Your Lab
Don't miss change to PAMA implementation. Your pathology practice or clinical lab can exp... Read more
Grasp Final Rule Impact for Your Lab
Don't miss change to PAMA implementation. Your pathology practice or clinical lab can exp... Read more
CPT® 2019:
Update BRCA1, BRCA2 Test Codes
Make sure you change from the ‘old way' to the ‘new way,' or lose pay. If your lab pe... Read more
Update BRCA1, BRCA2 Test Codes
Make sure you change from the ‘old way' to the ‘new way,' or lose pay. If your lab pe... Read more
Protect PHI:
Put 3 Skills in Your HIPAA-Compliance Toolbox
Foil insider breach threats. You may be ready for ransomware takedowns and other outside ... Read more
Put 3 Skills in Your HIPAA-Compliance Toolbox
Foil insider breach threats. You may be ready for ransomware takedowns and other outside ... Read more
Reader Question:
Learn sdLDL Clinical Value
Question: What is the purpose of the new lab test for small dense LDL cholesterol? ... Read more
Learn sdLDL Clinical Value
Question: What is the purpose of the new lab test for small dense LDL cholesterol? ... Read more
Reader Question:
Focus Hemorrhoidectomy Coding
Question: Our pathologist examined a second-degree hemorrhoidectomy specimen excised due t... Read more
Focus Hemorrhoidectomy Coding
Question: Our pathologist examined a second-degree hemorrhoidectomy specimen excised due t... Read more
You Be the Coder:
Grab Sentinel Node Pay
Question: We received a 3.2 cm scalp lesion excision, which the pathologist diagnosed as c... Read more
Grab Sentinel Node Pay
Question: We received a 3.2 cm scalp lesion excision, which the pathologist diagnosed as c... Read more
FOBT:
Q/A Scenarios Focus Coding for Colorectal Cancer Screening
Lab test method, purpose, drive code choice. With a growing number of lab tests that phys... Read more
Q/A Scenarios Focus Coding for Colorectal Cancer Screening
Lab test method, purpose, drive code choice. With a growing number of lab tests that phys... Read more
Molecular Tests:
More Q/A Scenarios Clarify CRC Genetic Test Options
Learn the genes associated with colon cancer. Although fecal occult blood test (FOBT) lab... Read more
More Q/A Scenarios Clarify CRC Genetic Test Options
Learn the genes associated with colon cancer. Although fecal occult blood test (FOBT) lab... Read more
HIPAA Compliance:
Take Heed of State Privacy-Law Enforcement
OCR isn't the only watchdog now. Your lab can't afford to get complacent about HIPAA viol... Read more
Take Heed of State Privacy-Law Enforcement
OCR isn't the only watchdog now. Your lab can't afford to get complacent about HIPAA viol... Read more
Reader Question:
Pinpoint CCI Edit Differences
Question: Could you please explain the difference between Medically Unlikely Edits and Mut... Read more
Pinpoint CCI Edit Differences
Question: Could you please explain the difference between Medically Unlikely Edits and Mut... Read more
Reader Question:
Exactly Match Panel-Code Test List
Question: Our lab received an order for blood electrolytes potassium, sodium, total calciu... Read more
Exactly Match Panel-Code Test List
Question: Our lab received an order for blood electrolytes potassium, sodium, total calciu... Read more
Reader Question:
Laser-Focus MAAA Codes for Proprietary Test
Question: Our lab performs a non-invasive prenatal test for trisomy 18 and 21 called Visib... Read more
Laser-Focus MAAA Codes for Proprietary Test
Question: Our lab performs a non-invasive prenatal test for trisomy 18 and 21 called Visib... Read more
You Be the Coder:
Find Most Specific Genetic Test Code
Question: I see that CPT® 2019 adds a new code for genetic testing for severe inherited c... Read more
Find Most Specific Genetic Test Code
Question: I see that CPT® 2019 adds a new code for genetic testing for severe inherited c... Read more