Pathology/Lab Coding Alert
CPT® 2021:
Master Microbiology Updates Including More SARS-CoV-2 Codes
Drop ‘multiple step' distinction for code selection. Before the ink was dry on the CPT... Read more
Master Microbiology Updates Including More SARS-CoV-2 Codes
Drop ‘multiple step' distinction for code selection. Before the ink was dry on the CPT... Read more
Compliance:
Check Out COVID-19 Exceptions That Impact Your Lab
Monitor PHE-related regulations. As COVID-19 cases are ramping up in many locations, coi... Read more
Check Out COVID-19 Exceptions That Impact Your Lab
Monitor PHE-related regulations. As COVID-19 cases are ramping up in many locations, coi... Read more
Practice Management:
Know Your Medicare AAP Recoupment Relief Options
Look for help with pandemic-related financial hardship. As the pandemic swirls up money w... Read more
Know Your Medicare AAP Recoupment Relief Options
Look for help with pandemic-related financial hardship. As the pandemic swirls up money w... Read more
You Be the Coder:
Clarify Breast/Lymph Bundles
Question: Our pathologist received tissue from a breast case in two separate containers ... Read more
Clarify Breast/Lymph Bundles
Question: Our pathologist received tissue from a breast case in two separate containers ... Read more
Reader Questions:
Determine Fluid Specimen Source
Question: Our pathologist evaluated a fluid specimen from an ovarian cyst submitted by an ... Read more
Determine Fluid Specimen Source
Question: Our pathologist evaluated a fluid specimen from an ovarian cyst submitted by an ... Read more
Reader Questions:
Avoid This ‘Uncertain’ Dx Trap
Question: The pathology report for a urinary bladder specimen simply states “neoplasm”... Read more
Avoid This ‘Uncertain’ Dx Trap
Question: The pathology report for a urinary bladder specimen simply states “neoplasm”... Read more
Reader Questions:
Bill for Completed Tissue Exam
Question: The surgeon sent five, separately identified colon polyp specimens from a colon... Read more
Bill for Completed Tissue Exam
Question: The surgeon sent five, separately identified colon polyp specimens from a colon... Read more
COVID-19:
Round Out SARS-CoV-2 Antibody Coding Options
Don't miss new quantitative test. With the latest CPT® code for SARS-CoV-2 antibody test... Read more
Round Out SARS-CoV-2 Antibody Coding Options
Don't miss new quantitative test. With the latest CPT® code for SARS-CoV-2 antibody test... Read more
Clip and Save:
Summarize SARS-CoV-2 Tests
With the fast and furious release of new CPT® codes for SARS-CoV-2 testing, it pays to ta... Read more
Summarize SARS-CoV-2 Tests
With the fast and furious release of new CPT® codes for SARS-CoV-2 testing, it pays to ta... Read more
FNA Extraction:
Follow NCCI Bundling Rules for FNA Cases
Beware pathologist's dual role. When your pathologist performs both the fine needle aspir... Read more
Follow NCCI Bundling Rules for FNA Cases
Beware pathologist's dual role. When your pathologist performs both the fine needle aspir... Read more
Compliance:
Check Out ABN Changes That Impact Your Lab
Don't let January 1 deadline sneak up on you. If you took the “free pass” and didn't... Read more
Check Out ABN Changes That Impact Your Lab
Don't let January 1 deadline sneak up on you. If you took the “free pass” and didn't... Read more
You Be the Coder:
Meet Pap Interpretation Requirements for 88141
Question: When we have a request for interpretation on a molecular pathology test in our l... Read more
Meet Pap Interpretation Requirements for 88141
Question: When we have a request for interpretation on a molecular pathology test in our l... Read more
Reader Questions:
Keep NPI Across State Lines
Question: Our pathology practice is moving from Louisiana to Texas. Do our pathologists ne... Read more
Keep NPI Across State Lines
Question: Our pathology practice is moving from Louisiana to Texas. Do our pathologists ne... Read more
Reader Questions:
Contact COVID-19 Patients for Plasma Donation
Question: We have physician clients ordering follow-up testing for patients who have ... Read more
Contact COVID-19 Patients for Plasma Donation
Question: We have physician clients ordering follow-up testing for patients who have ... Read more
ICD-10-CM 2021:
Prep for Lab- and Pathology-Relevant Diagnosis Codes
Kick off new diagnoses starting Oct. 1. Your lab needs to review the broad sweep of ICD-1... Read more
Prep for Lab- and Pathology-Relevant Diagnosis Codes
Kick off new diagnoses starting Oct. 1. Your lab needs to review the broad sweep of ICD-1... Read more
2021 ICD-10-CM:
Master Diagnosis Coding With Guideline Changes and More
COVID-19 instruction leads the way. Code additions, revisions, and deletions aren't the o... Read more
Master Diagnosis Coding With Guideline Changes and More
COVID-19 instruction leads the way. Code additions, revisions, and deletions aren't the o... Read more
Modifier 59:
Ramp Up X{EPSU} Use for Specific Lab Scenarios
Note NCCI Policy Manual updates. Maybe your pathology practice has received a payer notic... Read more
Ramp Up X{EPSU} Use for Specific Lab Scenarios
Note NCCI Policy Manual updates. Maybe your pathology practice has received a payer notic... Read more
Reader Questions:
Code Convalescent Plasma Infusion for COVID-19 Patient
Question: We have a hematopathologist who is performing convalescent plasma infusion for C... Read more
Code Convalescent Plasma Infusion for COVID-19 Patient
Question: We have a hematopathologist who is performing convalescent plasma infusion for C... Read more
Reader Questions:
‘Therapeutic’ is Key to Phlebotomy Code
Question: Our hematopathologist performed a therapeutic phlebotomy in the office for a pat... Read more
‘Therapeutic’ is Key to Phlebotomy Code
Question: Our hematopathologist performed a therapeutic phlebotomy in the office for a pat... Read more
You Be the Coder:
Zero in On G0452 Requirements
Question: When we have a request for interpretation on a molecular pathology test in ... Read more
Zero in On G0452 Requirements
Question: When we have a request for interpretation on a molecular pathology test in ... Read more
CPT® 2021 Lab Preview:
Peek at New Codes Unveiled by CLFS Annual Meeting
Look for additions to drug, molecular tests, and more. New clinical laboratory test codes... Read more
Peek at New Codes Unveiled by CLFS Annual Meeting
Look for additions to drug, molecular tests, and more. New clinical laboratory test codes... Read more
New SARS-CoV-2 Test:
Add 87426 to COVID-19 Diagnosis Arsenal
Greet infectious agent antigen detection option. With myriad nucleic acid tests available... Read more
Add 87426 to COVID-19 Diagnosis Arsenal
Greet infectious agent antigen detection option. With myriad nucleic acid tests available... Read more
Part B Pay:
Ace Pathology Billing With MPFS Database Tools
Thread the PC/TC needle for different services. If you've ever had problems billing your ... Read more
Ace Pathology Billing With MPFS Database Tools
Thread the PC/TC needle for different services. If you've ever had problems billing your ... Read more
You Be the Coder:
Count Blocks and Stains for 88312
Question: The pathology report describes a partial lung resection processed as six blocks ... Read more
Count Blocks and Stains for 88312
Question: The pathology report describes a partial lung resection processed as six blocks ... Read more
Reader Questions:
Follow Lymph Node Bundling Rules
Question: Our pathologist examined a spleen specimen with attached splenic nodes. I notice... Read more
Follow Lymph Node Bundling Rules
Question: Our pathologist examined a spleen specimen with attached splenic nodes. I notice... Read more
Reader Questions:
CMS Restarting Medical Review
Question: I've heard that CMS is suspending medical reviews for the duration of the COVID-... Read more
CMS Restarting Medical Review
Question: I've heard that CMS is suspending medical reviews for the duration of the COVID-... Read more
HCPCS Level II:
Don't Lose $49 per SARS-CoV-2 Test
Distinguish high-throughput codes. Many labs have ramped up testing for SARS-CoV-2,... Read more
Don't Lose $49 per SARS-CoV-2 Test
Distinguish high-throughput codes. Many labs have ramped up testing for SARS-CoV-2,... Read more
Case Study:
Seize Burn-Case Facts for Accurate Coding
Don't miss double duty for biopsy specimen. Patients with serious burns may require a ran... Read more
Seize Burn-Case Facts for Accurate Coding
Don't miss double duty for biopsy specimen. Patients with serious burns may require a ran... Read more
HIPAA:
Grasp COVID-19-Inspired OCR Privacy Reminder
Keep in mind ‘prior authorization.' With the flood of information about new pandemic he... Read more
Grasp COVID-19-Inspired OCR Privacy Reminder
Keep in mind ‘prior authorization.' With the flood of information about new pandemic he... Read more
Reader Questions:
Look Out for Modifier CR Use
Question: I've heard we are supposed to be using modifier CR on COVID-19 related claims. C... Read more
Look Out for Modifier CR Use
Question: I've heard we are supposed to be using modifier CR on COVID-19 related claims. C... Read more
Reader Questions:
Don't Miss Lymph Node Pay with Nephrectomy
Question: Our pathologist received a partial nephrectomy specimen and a separate container... Read more
Don't Miss Lymph Node Pay with Nephrectomy
Question: Our pathologist received a partial nephrectomy specimen and a separate container... Read more
Reader Questions:
Publicize SARS-CoV-2 Test Price
Question: Our lab doesn't typically post the cash price for tests on our website, but I've... Read more
Publicize SARS-CoV-2 Test Price
Question: Our lab doesn't typically post the cash price for tests on our website, but I've... Read more
You Be the Coder:
Match FNA 'Pass' to 'Evaluation Episode'
Question: The pathologist documented evaluating two “passes” from a thyroid FNA for sp... Read more
Match FNA 'Pass' to 'Evaluation Episode'
Question: The pathologist documented evaluating two “passes” from a thyroid FNA for sp... Read more
COVID-19:
Know Your Specimen Collection Billing Options
Master ‘G' codes for independent labs. With varied sites and personnel for COVID-19 lab... Read more
Know Your Specimen Collection Billing Options
Master ‘G' codes for independent labs. With varied sites and personnel for COVID-19 lab... Read more
New PLA Code:
Greet 0202U for Respiratory Panel That Includes SARS-Cov-2
Mesh use with existing test codes. In an off-cycle move, the AMA issued a new Proprietary... Read more
Greet 0202U for Respiratory Panel That Includes SARS-Cov-2
Mesh use with existing test codes. In an off-cycle move, the AMA issued a new Proprietary... Read more
Breast Case:
Steer Breast-Lump Code Choice With Path Report Details
Missed specimen identification could cost you $210. Coding for your pathologist's breast ... Read more
Steer Breast-Lump Code Choice With Path Report Details
Missed specimen identification could cost you $210. Coding for your pathologist's breast ... Read more
Reader Questions:
Let QW Save Your COVID-19 Test Claims
Question: We are a physician office lab and are performing some COVID-19 rapid lab tests, ... Read more
Let QW Save Your COVID-19 Test Claims
Question: We are a physician office lab and are performing some COVID-19 rapid lab tests, ... Read more
Reader Questions:
Welcome High-Throughput SARS-CoV-2 Test Codes
Question: I've heard there are new codes for SARS-CoV-2 lab tests using high-throughput in... Read more
Welcome High-Throughput SARS-CoV-2 Test Codes
Question: I've heard there are new codes for SARS-CoV-2 lab tests using high-throughput in... Read more
Reader Questions:
Check Payer for HPV Coding Direction
Question: Our lab performed an HPV test for a 40-year-old patient who has not had a gyneco... Read more
Check Payer for HPV Coding Direction
Question: Our lab performed an HPV test for a 40-year-old patient who has not had a gyneco... Read more
You Be the Coder:
Focus Ovary Procedure and Dx Codes
Question: Our pathologist received a right salpingo-oophorectomy specimen and identifies a... Read more
Focus Ovary Procedure and Dx Codes
Question: Our pathologist received a right salpingo-oophorectomy specimen and identifies a... Read more
Serological Testing:
Update SARS-CoV-2 Code Options for Antibody Tests
Master CPT® April 10 revisions. Whether your lab uses a laboratory-developed test or a c... Read more
Update SARS-CoV-2 Code Options for Antibody Tests
Master CPT® April 10 revisions. Whether your lab uses a laboratory-developed test or a c... Read more
Case Study:
Miss Dx or Payer and Lose Pap Test Pay
See how method impacts code choice. When your lab gets a Pap test order, you need to an... Read more
Miss Dx or Payer and Lose Pap Test Pay
See how method impacts code choice. When your lab gets a Pap test order, you need to an... Read more
ICD-10-CM:
Ace COVID-19 Dx Coding with 4 Tips
See how code order counts. Although your lab won't assign an ICD-10 code based on test ... Read more
Ace COVID-19 Dx Coding with 4 Tips
See how code order counts. Although your lab won't assign an ICD-10 code based on test ... Read more
Reader Question:
Don't Miss 2-Code Urine Culture Problem
Question: Our lab received two urine specimen tubes for complete urinalysis with reflex to... Read more
Don't Miss 2-Code Urine Culture Problem
Question: Our lab received two urine specimen tubes for complete urinalysis with reflex to... Read more
You Be the Coder:
Account for Multiple Respiratory Virus Tests
Question: Our lab often gets orders for both SARS-CoV-2 testing and testing for Influenza ... Read more
Account for Multiple Respiratory Virus Tests
Question: Our lab often gets orders for both SARS-CoV-2 testing and testing for Influenza ... Read more
COVID 19:
Greet New Diagnosis and Lab Test Codes
Monitor developments for your lab. With COVID-19 pandemic information changing daily, use... Read more
Greet New Diagnosis and Lab Test Codes
Monitor developments for your lab. With COVID-19 pandemic information changing daily, use... Read more
Toolkit:
Follow COVID-19 Developments
Learn key resources to stay up to date. With information related to the COVID-19 pandemic... Read more
Follow COVID-19 Developments
Learn key resources to stay up to date. With information related to the COVID-19 pandemic... Read more
CERT Report:
Highlight Laboratory Documentation Deficiency
Improve quality for ‘sufficient' records. Your lab undoubtedly strives for excellent do... Read more
Highlight Laboratory Documentation Deficiency
Improve quality for ‘sufficient' records. Your lab undoubtedly strives for excellent do... Read more
Reader Question:
Know When to Use 'Repeat' Modifier
Question: The lab performed four CK level tests for an ER patient within a 24-hour period,... Read more
Know When to Use 'Repeat' Modifier
Question: The lab performed four CK level tests for an ER patient within a 24-hour period,... Read more
Reader Question:
You Won't Miss Modifier GD
Question: I see that HCPCS 2020 deletes modifier GD. Does this impact coding for multiple ... Read more
You Won't Miss Modifier GD
Question: I see that HCPCS 2020 deletes modifier GD. Does this impact coding for multiple ... Read more
Reader Question:
Identify PSA Test Options
Question: Our lab performed repeat PSA tests for a patient who had a radical prostatectomy... Read more
Identify PSA Test Options
Question: Our lab performed repeat PSA tests for a patient who had a radical prostatectomy... Read more
Reader Question:
Learn Medicare Appeals Levels
Question: My Medicare MAC denied a claim I submitted, and I want to appeal the decision. W... Read more
Learn Medicare Appeals Levels
Question: My Medicare MAC denied a claim I submitted, and I want to appeal the decision. W... Read more
You Be the Coder:
Distinguish LEEP Specimens
Question: Our pathologist received a cervical LEEP specimen from a colposcopy with a loop ... Read more
Distinguish LEEP Specimens
Question: Our pathologist received a cervical LEEP specimen from a colposcopy with a loop ... Read more
Anatomic Pathology:
Challenge Dx and Procedure Coding Skills With This Uterine Case
Master hyperplasia terminology. Pathology cases involving uterine endometrium can hold ma... Read more
Challenge Dx and Procedure Coding Skills With This Uterine Case
Master hyperplasia terminology. Pathology cases involving uterine endometrium can hold ma... Read more
Novel Coronavirus:
Prepare for COVID-19 Impact at Your Lab
Know when to engage public health. Even if your lab doesn't currently test for COVID-19... Read more
Prepare for COVID-19 Impact at Your Lab
Know when to engage public health. Even if your lab doesn't currently test for COVID-19... Read more
Compliance:
Master HIPAA Breach Notification Rules
Preparation lowers risk and penalties. If your lab faces a breach of patient protected ... Read more
Master HIPAA Breach Notification Rules
Preparation lowers risk and penalties. If your lab faces a breach of patient protected ... Read more
Reader Question:
Don't Double-Dip Mohs Pathology
Question: We have a dermatology clinic client who sometimes sends our pathologist slides f... Read more
Don't Double-Dip Mohs Pathology
Question: We have a dermatology clinic client who sometimes sends our pathologist slides f... Read more
Reader Question:
Behavior Drives Tumor Dx
Question: The pathologist diagnosed a specimen as a pineocytoma. Which ICD-10 code should ... Read more
Behavior Drives Tumor Dx
Question: The pathologist diagnosed a specimen as a pineocytoma. Which ICD-10 code should ... Read more
You Be the Coder:
Distinguish FISH Codes for HER2/neu
Question: We have a pathology report for a breast biopsy exam, and the report states, “T... Read more
Distinguish FISH Codes for HER2/neu
Question: We have a pathology report for a breast biopsy exam, and the report states, “T... Read more
Case Study:
Sidestep Referred-Material Consultation Pitfalls
Beware unit of service impact. When your pathologist consults on material referred from a... Read more
Sidestep Referred-Material Consultation Pitfalls
Beware unit of service impact. When your pathologist consults on material referred from a... Read more
NCDs:
Integrate Diagnosis Changes into Your Coverage Rules
Avoid using truncated codes. Dragging your feet to incorporate the latest ICD-10-CM codes... Read more
Integrate Diagnosis Changes into Your Coverage Rules
Avoid using truncated codes. Dragging your feet to incorporate the latest ICD-10-CM codes... Read more
Clinical Lab:
Capture Celiac Disease Test Sequence
Focus molecular HLA typing. Testing protocols for celiac disease diagnosis can be a compl... Read more
Capture Celiac Disease Test Sequence
Focus molecular HLA typing. Testing protocols for celiac disease diagnosis can be a compl... Read more
Reader Question:
Master Stromal Tumor Diagnosis Coding
Question: The pathologist examined an esophageal biopsy from an esophagogastroduodenoscopy... Read more
Master Stromal Tumor Diagnosis Coding
Question: The pathologist examined an esophageal biopsy from an esophagogastroduodenoscopy... Read more
Reader Question:
Change Documentation With Care
Question: When we see that documentation doesn't match a code choice, we usually go back t... Read more
Change Documentation With Care
Question: When we see that documentation doesn't match a code choice, we usually go back t... Read more
Reader Question:
Code Reason for Hepatitis C Screen
Question: Our lab performs a hepatitis C screening for a Medicare patient with an injectio... Read more
Code Reason for Hepatitis C Screen
Question: Our lab performs a hepatitis C screening for a Medicare patient with an injectio... Read more
You Be the Coder:
Learn G0455 FMT Restriction
Question: Our pathologist works with a gastroenterologist at our hospital for fecal microb... Read more
Learn G0455 FMT Restriction
Question: Our pathologist works with a gastroenterologist at our hospital for fecal microb... Read more
CPT® 2020:
Master Molecular Pathology Code Updates
Don't miss Tier 2 to Tier 1 conversions. If your lab performs gene analyses, you need to ... Read more
Master Molecular Pathology Code Updates
Don't miss Tier 2 to Tier 1 conversions. If your lab performs gene analyses, you need to ... Read more
FNA:
Capture Each Step of Aspirate Biopsy Case
But beware bundled services. When your pathologist evaluates a fine needle aspiration (FN... Read more
Capture Each Step of Aspirate Biopsy Case
But beware bundled services. When your pathologist evaluates a fine needle aspiration (FN... Read more
Compliance:
Focus You Lab's HIPAA Policies for 2020
Train, monitor, modify to keep procedures current. Strengthening your HIPAA compliance to... Read more
Focus You Lab's HIPAA Policies for 2020
Train, monitor, modify to keep procedures current. Strengthening your HIPAA compliance to... Read more
Reader Question:
Search for 'Payable Diagnoses'
Question: We've always turned to our Medicare contractor's LCDs to find a list of pay... Read more
Search for 'Payable Diagnoses'
Question: We've always turned to our Medicare contractor's LCDs to find a list of pay... Read more
You Be the Coder:
Find Diagnosis, Procedure Codes for Drug Screen
Question: A clinician orders a drug test screen for a patient presenting with constricted ... Read more
Find Diagnosis, Procedure Codes for Drug Screen
Question: A clinician orders a drug test screen for a patient presenting with constricted ... Read more
CPT® 2020:
Take on 3 New Category I MAAA Codes
Distinguish codes for similar tests. When January 1 rolls around, you'll need to know abo... Read more
Take on 3 New Category I MAAA Codes
Distinguish codes for similar tests. When January 1 rolls around, you'll need to know abo... Read more
2020 Medicare Pay:
Learn MPFS Final Rule Impact for Your Pathology Lab
Pap interpretation takes big hit. Changes are coming down the pike for payment on some hi... Read more
Learn MPFS Final Rule Impact for Your Pathology Lab
Pap interpretation takes big hit. Changes are coming down the pike for payment on some hi... Read more
Compliance:
Embrace Stark Law Changes
Value-based care is driving the revisions. If your pathology practice has stumbled over S... Read more
Embrace Stark Law Changes
Value-based care is driving the revisions. If your pathology practice has stumbled over S... Read more
Reader Question:
Focus 'Medical Necessity' for Billing
Question: Sometimes we get denials for a procedure our pathologist performed due to lack o... Read more
Focus 'Medical Necessity' for Billing
Question: Sometimes we get denials for a procedure our pathologist performed due to lack o... Read more
Reader Question:
Capture Repeat Sodium Test Pay
Question: Our lab performed a basic metabolic panel (total calcium), followed by two sodiu... Read more
Capture Repeat Sodium Test Pay
Question: Our lab performed a basic metabolic panel (total calcium), followed by two sodiu... Read more
You Be the Coder:
Parse TB Test Coding
Question: Our lab received an order for an IGRA test for TB for a 30-year-old patient who ... Read more
Parse TB Test Coding
Question: Our lab received an order for an IGRA test for TB for a 30-year-old patient who ... Read more