Pathology/Lab Coding Alert
CPT® 2024:
Spotlight Blood and Tumor Cancer Coding With New and Revised Codes
Use this glossary for better understanding. You'll find a host of CPT® 2024 updates tha... Read more
Spotlight Blood and Tumor Cancer Coding With New and Revised Codes
Use this glossary for better understanding. You'll find a host of CPT® 2024 updates tha... Read more
CPT® 2024:
Add to the Trove of Category III Slide Digitization Codes
Match 30 new add-on codes to the appropriate base procedure code. Last year, CPT® added... Read more
Add to the Trove of Category III Slide Digitization Codes
Match 30 new add-on codes to the appropriate base procedure code. Last year, CPT® added... Read more
ICD-10-CM:
Test Your Breast Cancer Dx Coding Prowess With This Quiz
Tip: Make sure you check coding guidelines. Given a narrative diagnosis in a breast case ... Read more
Test Your Breast Cancer Dx Coding Prowess With This Quiz
Tip: Make sure you check coding guidelines. Given a narrative diagnosis in a breast case ... Read more
Coding Quiz Answers:
See if Your Breast Cancer Dx Coding Measures Up
Hone your skills with the following solutions. After you've answered the preceding quiz ... Read more
See if Your Breast Cancer Dx Coding Measures Up
Hone your skills with the following solutions. After you've answered the preceding quiz ... Read more
You Be The Coder:
Focus Intraoperative Consult Coding
Question: The surgeon requests an intraoperative consultation for a lumpectomy specim... Read more
Focus Intraoperative Consult Coding
Question: The surgeon requests an intraoperative consultation for a lumpectomy specim... Read more
Reader Question:
Capture Testosterone Response Test
Question: Our lab performs two testosterone tests, one baseline, and one following th... Read more
Capture Testosterone Response Test
Question: Our lab performs two testosterone tests, one baseline, and one following th... Read more
Reader Question:
Beware “Soft Tissue Mass” Dx
Question: Our pathologist received a specimen that the op report identified as “so... Read more
Beware “Soft Tissue Mass” Dx
Question: Our pathologist received a specimen that the op report identified as “so... Read more
Reader Question:
Ask MACs About Claims-Based NCCI Troubles
Question: If I have a question about appealing a claim that has been denied due to a ... Read more
Ask MACs About Claims-Based NCCI Troubles
Question: If I have a question about appealing a claim that has been denied due to a ... Read more
Colon Cancer:
Code This Lynch Syndrome Case
Capture family history for medical necessity. When your pathologist examines colon polyp(... Read more
Code This Lynch Syndrome Case
Capture family history for medical necessity. When your pathologist examines colon polyp(... Read more
NAAT:
There’s a Catch to Multiple STI Organism Coverage
Look for payers ‘bundling' payment. If you've wondered why you're getting denials, or a... Read more
There’s a Catch to Multiple STI Organism Coverage
Look for payers ‘bundling' payment. If you've wondered why you're getting denials, or a... Read more
Practice Management:
Bust 3 Myths About Medicare Participation Status
Choose wisely for your physicians. If you think choosing to be “non-PAR” status with... Read more
Bust 3 Myths About Medicare Participation Status
Choose wisely for your physicians. If you think choosing to be “non-PAR” status with... Read more
Reader Questions:
Spotlight pH Test Coding
Question: We usually bill pH as 82803, for a blood specimen, but we got an order for an es... Read more
Spotlight pH Test Coding
Question: We usually bill pH as 82803, for a blood specimen, but we got an order for an es... Read more
Reader Questions:
Site Identifies Lesion Dx
Question: The pathologist examined a breast biopsy from the “central portion” of the b... Read more
Site Identifies Lesion Dx
Question: The pathologist examined a breast biopsy from the “central portion” of the b... Read more
Reader Questions:
Grasp HIPAA Family History Rules
Question: When our pathologist receives a tissue specimen, the ordering physician sometime... Read more
Grasp HIPAA Family History Rules
Question: When our pathologist receives a tissue specimen, the ordering physician sometime... Read more
You Be the Coder:
Further Testing Needed for Shigellosis Details
Question: The ordering physician requested a stool culture for a patient with severe stoma... Read more
Further Testing Needed for Shigellosis Details
Question: The ordering physician requested a stool culture for a patient with severe stoma... Read more
Case Study:
Dissect Cervical LEEP Details for Best Code Selection
Look for surgical procedure clues. You could stand to lose $221 if you make the wrong ca... Read more
Dissect Cervical LEEP Details for Best Code Selection
Look for surgical procedure clues. You could stand to lose $221 if you make the wrong ca... Read more
Medicare Physician Fee Schedule:
Grasp 2024 Proposed Rule Impact on Your Lab
Look for big CF cut … again. If you want a peek at your lab's future — financial an... Read more
Grasp 2024 Proposed Rule Impact on Your Lab
Look for big CF cut … again. If you want a peek at your lab's future — financial an... Read more
Artificial Intelligence:
Use Caution With AI Staff Recruiting Tools
Avoid legal pitfalls. Yet another transformative technology is seeping into the healthc... Read more
Use Caution With AI Staff Recruiting Tools
Avoid legal pitfalls. Yet another transformative technology is seeping into the healthc... Read more
Pocket This CF Formula Explainer
If figuring out how and why the Centers for Medicare & Medicaid Services (CMS) adjusts... Read more
If figuring out how and why the Centers for Medicare & Medicaid Services (CMS) adjusts... Read more
Reader Questions:
Parse This Glucose Scenario
Question: The lab performed three glucose tests on the same date and billed 82947 x 3... Read more
Parse This Glucose Scenario
Question: The lab performed three glucose tests on the same date and billed 82947 x 3... Read more
Reader Questions:
Ensure That You’re Using Updated ABN
Question: I'm new to our lab, but I noticed that the ABN form we're using is differen... Read more
Ensure That You’re Using Updated ABN
Question: I'm new to our lab, but I noticed that the ABN form we're using is differen... Read more
Reader Questions:
Figure Out When Medicare is Primary
Question: We have a patient on Medicare who is also insured through a group health pl... Read more
Figure Out When Medicare is Primary
Question: We have a patient on Medicare who is also insured through a group health pl... Read more
You Be the Coder:
Don’t Count FNA ‘Passes’
Question: Our pathologist evaluated FNA thyroid specimens from three “passes.” Fi... Read more
Don’t Count FNA ‘Passes’
Question: Our pathologist evaluated FNA thyroid specimens from three “passes.” Fi... Read more
ICD-10-CM:
Get Ready for 2024 Dx Codes Relevant to Your Lab
Plan to implement the changes on Oct. 1 Nearly 400 ICD-10-CM code additions as well as ma... Read more
Get Ready for 2024 Dx Codes Relevant to Your Lab
Plan to implement the changes on Oct. 1 Nearly 400 ICD-10-CM code additions as well as ma... Read more
Drug Testing:
3 Tips Spotlight Drug Dx and Procedure Coding
Know the reason for the test. Labs perform drug analyses using many different methods for... Read more
3 Tips Spotlight Drug Dx and Procedure Coding
Know the reason for the test. Labs perform drug analyses using many different methods for... Read more
Final Rule:
Notice Policy Changes Affecting Medicare Advantage Plans
Look for equity and utilization review. With many patients using Medicare Advantage plans... Read more
Notice Policy Changes Affecting Medicare Advantage Plans
Look for equity and utilization review. With many patients using Medicare Advantage plans... Read more
Reader Questions:
Don’t Ignore HIPAA Breach Rules
Question: We identified a small data breach in our lab system that impacted about 145 pati... Read more
Don’t Ignore HIPAA Breach Rules
Question: We identified a small data breach in our lab system that impacted about 145 pati... Read more
Reader Questions:
Distinguish Cytopathology Specimens
Question: The pathologist diagnoses a CSF specimen that was collected in fluid and then co... Read more
Distinguish Cytopathology Specimens
Question: The pathologist diagnoses a CSF specimen that was collected in fluid and then co... Read more
You Be the Coder:
Rely on 81479
Question: A provider ordered a full gene sequence analysis of BRCA2 plus a BRCA1 known fam... Read more
Rely on 81479
Question: A provider ordered a full gene sequence analysis of BRCA2 plus a BRCA1 known fam... Read more
Renal Case:
Capture Each Procedure for This Kidney Biopsy Exam
Turn to detailed diagnosis code. Kidney pathology often involves several specialized tech... Read more
Capture Each Procedure for This Kidney Biopsy Exam
Turn to detailed diagnosis code. Kidney pathology often involves several specialized tech... Read more
Separate Service:
Tone Down Modifier 59 Use for Cleaner Claims
Use alternatives when you can. Modifier 59 (Distinct procedural service) frequently top... Read more
Tone Down Modifier 59 Use for Cleaner Claims
Use alternatives when you can. Modifier 59 (Distinct procedural service) frequently top... Read more
Compliance:
Master 5 Tactics to Minimize Denials
Learning patterns in your lab could prevent future problems. No one likes filing appeals ... Read more
Master 5 Tactics to Minimize Denials
Learning patterns in your lab could prevent future problems. No one likes filing appeals ... Read more
Reader Questions:
Distinguish Respiratory Pathogen Codes
Question: Our lab performs an amplified probe infectious agent detection panel for four re... Read more
Distinguish Respiratory Pathogen Codes
Question: Our lab performs an amplified probe infectious agent detection panel for four re... Read more
Reader Questions:
Spotlight Medicare Overpayment Rules
Question: Who is responsible for identifying and correcting overpayment in any Medicare re... Read more
Spotlight Medicare Overpayment Rules
Question: Who is responsible for identifying and correcting overpayment in any Medicare re... Read more
You Be the Coder:
Look to Documentation for ‘Acute’ or ‘Chronic’ Designation
Question: How can I tell if a condition is “acute” or “chronic?” Our pathologist e... Read more
Look to Documentation for ‘Acute’ or ‘Chronic’ Designation
Question: How can I tell if a condition is “acute” or “chronic?” Our pathologist e... Read more
Laboratory:
Get Ready for Summer Fun That Sends Lab Test Orders Your Way
Rashes and bites and burns, oh my! With people spending more time outdoors this season, y... Read more
Get Ready for Summer Fun That Sends Lab Test Orders Your Way
Rashes and bites and burns, oh my! With people spending more time outdoors this season, y... Read more
ICD-10-CM:
Learn How ‘With’ Impacts Your Dx Coding
Don't miss guideline instructions for two conditions. When it comes to diagnosis coding, ... Read more
Learn How ‘With’ Impacts Your Dx Coding
Don't miss guideline instructions for two conditions. When it comes to diagnosis coding, ... Read more
Compliance:
Flex Your HIPAA Know-How With These 3 Tips
PHE's end means the end of HIPAA waivers. Now that the COVID-19 public health emergency (... Read more
Flex Your HIPAA Know-How With These 3 Tips
PHE's end means the end of HIPAA waivers. Now that the COVID-19 public health emergency (... Read more
Reader Questions:
Explain 88323 Reporting
Question: When the pathologist receives material from another physician for slide pre... Read more
Explain 88323 Reporting
Question: When the pathologist receives material from another physician for slide pre... Read more
Reader Questions:
Figure Out Fingerstick Pay
Question: Our lab collects capillary blood by fingerstick for certain tests rather th... Read more
Figure Out Fingerstick Pay
Question: Our lab collects capillary blood by fingerstick for certain tests rather th... Read more
You Be the Coder:
Master Coding for Pre-Transfusion Tests
Question: What's the difference between type, screen and crossmatch for blood transfu... Read more
Master Coding for Pre-Transfusion Tests
Question: What's the difference between type, screen and crossmatch for blood transfu... Read more
Clinical Lab:
Stay In the Clear With These Urinalysis Coding Rules
CLIA license level is key. Urinalysis (UA) testing is a ubiquitous part of analyzing a pa... Read more
Stay In the Clear With These Urinalysis Coding Rules
CLIA license level is key. Urinalysis (UA) testing is a ubiquitous part of analyzing a pa... Read more
Transfusion Medicine:
Roundup CPT® Codes from Typing to Transfusion
See when the pathologist joins the fray. Blood transfusions are a key part of treatment f... Read more
Roundup CPT® Codes from Typing to Transfusion
See when the pathologist joins the fray. Blood transfusions are a key part of treatment f... Read more
Practice Management:
Avoid Undercoding Errors With Accurate Documentation
Lost pay isn't the only potential penalty. Coders worry about “upcoding” and charging... Read more
Avoid Undercoding Errors With Accurate Documentation
Lost pay isn't the only potential penalty. Coders worry about “upcoding” and charging... Read more
Reader Questions:
Check MUE Table for ‘Override’ Guidance
Question: Our pathologist extracted two FNA specimens, one from a breast lesion in t... Read more
Check MUE Table for ‘Override’ Guidance
Question: Our pathologist extracted two FNA specimens, one from a breast lesion in t... Read more
Reader Questions:
Notice PHE’s End
Question: Did the COVID-19 public health emergency expire (PHE)? Florida Subscriber ... Read more
Notice PHE’s End
Question: Did the COVID-19 public health emergency expire (PHE)? Florida Subscriber ... Read more
You Be the Coder:
Code This Bone Case
Question: We have a pathology report for a bone osteoma exam that includes mention of... Read more
Code This Bone Case
Question: We have a pathology report for a bone osteoma exam that includes mention of... Read more
GSPs:
Fine Tune Genomic Test Coding With CPT® 2023 Revisions
Don't lose pay for separate RNA, DNA testing. With more RNA testing working its way into ... Read more
Fine Tune Genomic Test Coding With CPT® 2023 Revisions
Don't lose pay for separate RNA, DNA testing. With more RNA testing working its way into ... Read more
Anatomic Pathology:
Learn These Tonsil Specimen Pitfalls and Opportunities
See what you need to know for Dx coding. Tonsils may be a common pathology specimen, but ... Read more
Learn These Tonsil Specimen Pitfalls and Opportunities
See what you need to know for Dx coding. Tonsils may be a common pathology specimen, but ... Read more
Documentation:
Create Complete Records by Knowing When and How to Query
Learn these guidelines to get proper lab pay. You've heard the coding adage, “if it wa... Read more
Create Complete Records by Knowing When and How to Query
Learn these guidelines to get proper lab pay. You've heard the coding adage, “if it wa... Read more
Reader Questions:
Don’t Miss ICD-10 Update
Question: Someone told me that there are new ICD-10-CM codes effective in April, but... Read more
Don’t Miss ICD-10 Update
Question: Someone told me that there are new ICD-10-CM codes effective in April, but... Read more
Reader Questions:
Check Coverage for GI Pathogen NA Tests
Question: Our lab is getting denials for testing for GI pathogens such as one of the ... Read more
Check Coverage for GI Pathogen NA Tests
Question: Our lab is getting denials for testing for GI pathogens such as one of the ... Read more
You Be the Coder:
Focus ER+ Coding
Question: I have a pathology report that just indicates, “breast tumor tissue ER 2... Read more
Focus ER+ Coding
Question: I have a pathology report that just indicates, “breast tumor tissue ER 2... Read more
Clinical Lab:
RSV is Up, Are You Up to RSV Coding?
Watch out for ‘multiplex.' With burgeoning cases of respiratory syncytial virus (RSV) t... Read more
RSV is Up, Are You Up to RSV Coding?
Watch out for ‘multiplex.' With burgeoning cases of respiratory syncytial virus (RSV) t... Read more
Case Study:
Capture Hormone Testing for Breast Cancer Case
See how procedure date can alter coding. When your pathologist examines a breast specime... Read more
Capture Hormone Testing for Breast Cancer Case
See how procedure date can alter coding. When your pathologist examines a breast specime... Read more
OIG Compliance Alert:
Protect Your Lab From COVID-19-Related Fraud Charges
Document 3 key items for clean claims. Ballooning lab utilization and questionable “add... Read more
Protect Your Lab From COVID-19-Related Fraud Charges
Document 3 key items for clean claims. Ballooning lab utilization and questionable “add... Read more
Reader Questions:
Keep On Top of QPP Updates
Question: I'm newly in charge of the QPP program for our practice, and I'm wondering ... Read more
Keep On Top of QPP Updates
Question: I'm newly in charge of the QPP program for our practice, and I'm wondering ... Read more
Reader Questions:
Think ‘Post’ Equals ‘Long’ COVID
Question: We received an order for some lab tests and the physician stated that the d... Read more
Think ‘Post’ Equals ‘Long’ COVID
Question: We received an order for some lab tests and the physician stated that the d... Read more
Reader Questions:
Don’t Make This Locum Tenens Mistake
Question: We have a pathologisthas left our practice, and we're wondering if we can s... Read more
Don’t Make This Locum Tenens Mistake
Question: We have a pathologisthas left our practice, and we're wondering if we can s... Read more
You Be the Coder:
Choose One Code for Aneuploidy Plus SCA
Question: How should we code for fetal aneuploidy (trisomy 21, 18, and 13, which we a... Read more
Choose One Code for Aneuploidy Plus SCA
Question: How should we code for fetal aneuploidy (trisomy 21, 18, and 13, which we a... Read more
CPT® 2023:
Focus On Drug Metabolism Test Codes
See how gene analysis can personalize medication choices. CPT® 2023 is keeping up with t... Read more
Focus On Drug Metabolism Test Codes
See how gene analysis can personalize medication choices. CPT® 2023 is keeping up with t... Read more
Compliance:
Reform Your Billing Rules for Colorectal Cancer Screening
Catch up on expanded Medicare coverage. With Medicare updates to coverage rules for col... Read more
Reform Your Billing Rules for Colorectal Cancer Screening
Catch up on expanded Medicare coverage. With Medicare updates to coverage rules for col... Read more
Medicare Update:
Learn 4 CAA Actions That Will Help Your Lab
Conversion factor relief is just the beginning. Following the outcry over impending Medi... Read more
Learn 4 CAA Actions That Will Help Your Lab
Conversion factor relief is just the beginning. Following the outcry over impending Medi... Read more
Reader Questions:
Capture Various Microbiology Tests
Question: The lab received corneal scrapping specimen from a patient with infected ke... Read more
Capture Various Microbiology Tests
Question: The lab received corneal scrapping specimen from a patient with infected ke... Read more
Reader Questions:
Discern Qualitative vs. Quantitative Immuno Stains
Question: We're staining breast specimens with ER, PR, Her-2/neu, and Ki67. Should I ... Read more
Discern Qualitative vs. Quantitative Immuno Stains
Question: We're staining breast specimens with ER, PR, Her-2/neu, and Ki67. Should I ... Read more
Reader Questions:
Identify Multiple Specimens from Colonoscopy
Question: The pathologist received contents from a colonoscopy procedure in one conta... Read more
Identify Multiple Specimens from Colonoscopy
Question: The pathologist received contents from a colonoscopy procedure in one conta... Read more
You Be the Coder:
Embrace Specimen Flexibility for TPMT Test
Question: Our lab is performing a test for “Thiopurine Methyltransferase (TPMT), ... Read more
Embrace Specimen Flexibility for TPMT Test
Question: Our lab is performing a test for “Thiopurine Methyltransferase (TPMT), ... Read more
Case Study:
Capture Colon Resection Pay with 4 Tips
Hint:Get the unit of service right. A colon resection pathology report might represent mu... Read more
Capture Colon Resection Pay with 4 Tips
Hint:Get the unit of service right. A colon resection pathology report might represent mu... Read more
MPFS 2023:
Appraise Final Rule Features That Affect Lab Pay
Catch a break on specimen collection fees. Look for big changes in the Medicare Physician... Read more
Appraise Final Rule Features That Affect Lab Pay
Catch a break on specimen collection fees. Look for big changes in the Medicare Physician... Read more
ICD-10-CM:
See How Ordering Dx Focuses Drug Test Procedure
Study this case to understand drug toxicity diagnoses. When your lab receives a request f... Read more
See How Ordering Dx Focuses Drug Test Procedure
Study this case to understand drug toxicity diagnoses. When your lab receives a request f... Read more
Reader Question:
Don’t Tread on HIPAA Right of Access
Question: We have a patient with a large balance who has not responded to requests fo... Read more
Don’t Tread on HIPAA Right of Access
Question: We have a patient with a large balance who has not responded to requests fo... Read more
Reader Question:
Know That PHE Has Time Limits
Question: Why do we keep hearing that the COVID-19 PHE is extended — does it last o... Read more
Know That PHE Has Time Limits
Question: Why do we keep hearing that the COVID-19 PHE is extended — does it last o... Read more
You Be the Coder:
Look to Specific Organism Codes
Question: We currently are performing testing for Ehrlichia/Anaplasma, a panel which ... Read more
Look to Specific Organism Codes
Question: We currently are performing testing for Ehrlichia/Anaplasma, a panel which ... Read more
Medicare Update:
Brace for 2023 Physician Fee Schedule Pay Cut
Deal with negative 4.5 percent CF adjustment unless Congress intervenes. Following broad ... Read more
Brace for 2023 Physician Fee Schedule Pay Cut
Deal with negative 4.5 percent CF adjustment unless Congress intervenes. Following broad ... Read more
Compliance:
Use Modifiers to Defeat ‘Duplicate Claims’ Denials
Follow payer preference for billing success. When your lab repeats a clinical diagnostic... Read more
Use Modifiers to Defeat ‘Duplicate Claims’ Denials
Follow payer preference for billing success. When your lab repeats a clinical diagnostic... Read more
CPT® 2023:
Check Out Appendix S for AI Taxonomy
See how clinicians may interact with the machine. Maybe you didn't hear that the CPT® E... Read more
Check Out Appendix S for AI Taxonomy
See how clinicians may interact with the machine. Maybe you didn't hear that the CPT® E... Read more
Reader Question:
Capture Each Special Stain
Question: Our lab received a BAL specimen and used a liquid based preparation, then p... Read more
Capture Each Special Stain
Question: Our lab received a BAL specimen and used a liquid based preparation, then p... Read more
Reader Question:
Choose Specific GAD Code
Question: The lab performed an ELISA test for glutamic acid decarboxylase antibody on a se... Read more
Choose Specific GAD Code
Question: The lab performed an ELISA test for glutamic acid decarboxylase antibody on a se... Read more
You Be the Coder:
Catch the Cell Block Restriction
Question: We received a denial for a case in which the pathologist interpreted FNA specime... Read more
Catch the Cell Block Restriction
Question: We received a denial for a case in which the pathologist interpreted FNA specime... Read more