1. baroquecoder

    Physician orders for laboratory tests

    Clinic is stating they placed an order for urinalysis 'digitally' so they don't need to submit documentation for the UA. I'm unable to code it as there is no diagnosis or intent for the procedure indicated. What are the documentation requirements for a physician ordered laboratory test...
  2. C

    86003 and 86001 laboratory

    Hi, Has anyone experienced these codes being denied by medicare if the 86003 is over 50 we add another line with modifier 91 and if 86001 is over 20 we do the same . Medicare has been denying the 2nd lines and we have to appeal. Is there another way to keep these from denying? Thank you!
  3. C

    Urinary Drug Testing Inconsistencies Coding

    Does inconsistent lab results warrant an upcoding in the definitive CPT code? Ex: if we tested 7 drug classes (G0480) and the patient tested positive on 5 of those classes in which we performed additional testing to test the quantity, does that warrant a G0481 due to the additional testing?
  4. N

    Career advice needed!

    My wife is itching to do something different. She has a PhD in Immunology and Microbiology. She is also a licensed Cytotechnologist (specializes in diagnosing cancer at the cellular level) and doesnt care to work in the lab or teach any longer. She is considering pursuing a CPC with thoughts...
  5. W

    Pathology Immunohistochemistry PD-L1 (immunohistochemistry clone 22C3)

    The PD-L1 companion diagnostic test for Keytruda (immunohistochemistry clone 22C3) is interpreted using a Tumor Proportion Score (TPS); however, the result that is rendered is qualitative and the package insert from Dako indicates that this is a “qualitative” test. With this logic, our...
  6. N

    Cpt code globulin

    HI! How will you CPT code GLOBULIN alone term? Thanks in advance for the answers.
  7. M

    2017 change for strep cpt 87430?

    Has anyone had any issues with ordering cpt 87430 with J02.9 sore throat as a diagnosis? As of 10.1.16, since our ICD 10 update, our computer system is not allowing 87430 to be ordered for this dx. Does anyone know if there has been a change for this? Thanks in advance, Mariann Dalton
  8. Walker22

    Definitive Drug Testing for Cigna

    Cigna has recently released a drug testing policy that allows 8 definitive tests per date of service. Due to this limitation, they have determined that G0482 and G0483 are not medically necessary (because both codes exceed the 8 test maximum) and not payable. My lab now has a coding dilemma: 1...
  9. N

    Lab services for Home Health patients- covered/not covered by Medicare??

    Question: A client (independent lab) is working with an Assisted Living Facility to provide lab services to its residents. The ALF has stated that when their residents are under home health care, "they don't get paid for lab services". Would laboratory services not be reimbursed by Medicare to...
  10. C

    statutory exclusion labs

    So, I have been doing some research on labs and found most labs' status indicator is X (statutory exclusion-these codes represent an item or service that is not in the statutory definition of "physicians services" for the fee schedule payment purposes. No RVU's or payment amounts are shown for...