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Pathology/Lab Coding Alert

More Than a 'Fee' List -- Harness MPFS Policy Rules for TC/PC
Let status indicators show you how to get paidThe Medicare Physician Fee Schedule (MPFS) j... Read more
Will Medicare Pay? Fee Schedule Status Indicators Hold the Answer
Check out Medicare's online tool to speed up your searchPrice isn't everything--or the onl... Read more
3 Tips Keep Your Endocervical Coding on the Up and Up
Don't use Pap codes for endocervical -brushing biopsy-Following an abnormal Pap, your path... Read more
READER QUESTIONS:
Pinpoint ICD-9 Code With These Steps
Question: Is giant cell tumor of the tendon sheath a benign or malignant neoplasm? I-m hav... Read more
READER QUESTIONS:
Payer Determine Non-Gyn Cytology Rules
Question: We have a CSF specimen sent for cytology that we processed as a direct smear and... Read more
READER QUESTIONS:
Watch for Same-Incision Biopsy/Aspiration
Question: Our pathologist removed and examined bone-marrow aspiration and biopsy specimens... Read more
READER QUESTIONS:
Distinguish Qualitative Fecal Lactoferrin
Question: The lab provided two fecal lactoferrin measurements from specimens taken during ... Read more
You Be the Coder:
Capture Each Organism -- Here's How
Question: We routinely test post-transplant patients for BK virus by PCR (87798) and quant... Read more
Avoid Missteps With Clinical Lab Professional Services -- Here's How
Apply these tactics for reporting 80500-80502 and interpretationsWhen your pathologist pro... Read more
Think CCI Halts Clinical Pathology Consultation? Think Again
Heed consult rules and dodge 80500 payment woes Keep your eye on the difference between la... Read more
No Diagnosis? No Problem With This Signs-and-Symptoms Tip
Don't fall prey to this incomplete diagnosis pitfallThe pathologist reports -normal cells-... Read more
READER QUESTIONS:
Brush Up on Cervical Anatomy
Question: How should we code endocervical brushings collected in cytology fixative and mad... Read more
READER QUESTIONS:
Don't Miss Specimen Prep Pay
Question: Our lab prepares paraffin-embedded tissue for microarray analysis by the patholo... Read more
READER QUESTIONS:
Capture Each Microbiology Step
Question: When we perform a combined test for definitive identification and MIC drug sensi... Read more
READER QUESTIONS:
Watch for MUE Unit-of-Service Limits
Question: I-ve heard that Medicare has new edits called MUEs that are similar to CCI edits... Read more
READER QUESTIONS:
Sputum Code Depends on Preparation
Question: Our lab received a sputum specimen from an HIV/AIDS patient with suspected pneum... Read more
You Be the Coder:
Test Your Enhancement Broth Know-How
Question: If our microbiology lab performs a vaginal smear culture on an enhancement broth... Read more
Proposed G Code Would Complicate A1C Coding -- Find Out How
CMS proposes to eliminate 83036 and 83037 pay After upping the ante on the 2007 fee s... Read more
Don't Miss Out on Extra Diabetes Pay
Think you can't bill Medicare for 2 screenings per year? Think again Fact: The United... Read more
Sneak Preview:
Get Ready for 2008 Laboratory Codes
Watch for metabolic panel, immunology and more A new -unlisted antigen- code should c... Read more
Correction:
Prothrombin Time
Pathology/Lab Coding Alert Vol. 8, No. 9 incorrectly identified the prothrombin time tes... Read more
Reader Question:
CCI Removes Troublesome Pap Bundle
Question: When our lab performs an automated Pap smear for a Medicare patient that req... Read more
Reader Question:
Limit 85060 to Inpatients
Question: I bill for a hospital lab and have noticed that I get inconsistent payment fro... Read more
Reader Question:
Surgical or Cytology Case Is Unit-of-Service
Question: I-m trying to understand how to use codes for pathology consultation on specim... Read more
Reader Question:
Use Most Specific Code for FNA
Question: Sometimes our lab prepares FNA slides using methods other than direct smear. For... Read more
Reader Question:
Count Markers for Flow Cytometry
Question: How should I report the following flow cytometry panel: three tubes containing... Read more
You Be the Coder:
Distinguish Thyroidectomy and Lobectomy
Question: Our pathologist examined two frozen section blocks during surgery from the pat... Read more
Forgetting Preparation With Arrays Could Cost You $$
  CCI limits some -- but not all -- molecular diagnostics The upside to the lates... Read more
Keep Alert -- No Pathologist, No Pay for Array Testing Codes
Use TC, 26 to get your fair share If you don't have a pathologist supervising your mo... Read more
Pap Coding Primer:
Negotiate ICD-9 Maze for Medical Necessity -- Here's How
Reason, frequency make or break claims You can't call the shots when a physician a... Read more
Pair Paps Correctly or Lose Interpretation Pay
Latest CCI enforces P3001 coding rules Your pathologist interprets an abnormal screeni... Read more
Reader Questions:
Report Medication Monitoring Diagnosis
Question: When the lab performs tests for medication monitoring, what ICD-9 codes should... Read more
Reader Questions:
Examine Listed Specimen Choices
Question: The pathology report lists a specimen as a diverticulum of the small intestine... Read more
Reader Questions:
Watch for CBC Components
Question: A physician orders RBC, WBC and platelet count, which the lab performs on an a... Read more
Reader Questions:
Add Up Molecular Diagnostics Steps
  Question: The lab receives a paraffin-fixed specimen for T-cell receptor (TCR)... Read more
You Be the Coder:
Count Stationary/Mobile Phases
Question: I-m trying to understand how to code chromatography lab procedures based on st... Read more
Colon Diagnosis Primer ~ Polyp or Not, Choose the Right ICD-9 Code -- Every Time
Tip: Dx drives follow-up frequency rules With the implementation of pay-for-performance, ... Read more
Location, Location, Location Dictates Colon Cancer Codes
Know primary and metastatic site or risk misdiagnosis You can't assign the proper ... Read more
NPI Directory Scheduled at Last -- Access June 28, CMS Says
HHS to grant free access on the Internet You finally have a date that you can expect a Na... Read more
Capture Each Antibody Test to Maximize Ethical Pay
Don't miss specific virus type or Ig class If you don't report a separate code for each v... Read more
Immunology Basics ~ Immunoglobulin Class Confusing? Here's What You Need to Know
Our experts decode IgG, IgM and more When the test order looks like alphabet soup, select... Read more
CORRECTION
The Endometrial Cancer Coding Case Study on page 52 of Pathology/Lab Coding Alert, Volume ... Read more
Reader Question ~ Specimen Defines Frozen Section Codes
Question: Our pathologist consulted on a breast resection and examined frozen section slid... Read more
Reader Question ~ Watch A1C Frequency
Question: Our lab has very inconsistent results with getting paid for glycosylated hemoglo... Read more
Reader Question ~ Don't Miss Special Biopsy Test
Question: The pathologist examines a stomach biopsy taken during an esophagogastroduodenos... Read more
Reader Question ~ Code Specific Influenza Condition
Question: When a physician orders an H. influenza antibody blood test stating that the pat... Read more
You Be the Coder ~ Use Most Specific Interpretation Code
Question: When our pathologist interprets and reports/discusses with a physician the resul... Read more
Correction to article.
Correction: The Endometrial Cancer Coding Case Study on page 52 of Pathology/Lab Coding Al... Read more
Coding Checkup:
Take 5 Minutes to Get Ready for October ICD-9 Changes
New codes show medical necessity, pathologist's diagnosisFrom herpesvirus lab tests to non... Read more
Bust These ICD-9 Coding Myths
Report the right code -- every timeThe key to payment may be your ICD-9 code--so choose it... Read more
Coding Case Study:
Knock Out These 3 Hurdles in Endometrial Cancer Case
Hint: Capture separate specimens to boost your bottom lineIf your pathologist examines a c... Read more
READER QUESTIONS:
Don't Double-Dip Cytopathology Methods
Question: Sometimes we process CSF both by cytospin and thin-layer preparation because the... Read more
READER QUESTIONS:
Clarify Lung Biopsy/Resection
Question: If the pathologist examines a lung specimen that the surgeon identifies as a -lu... Read more
READER QUESTIONS:
Choose Urinalysis by Method/Analyte
Question: When we perform a urinalysis for bilirubin, hemoglobin, leukocytes, pH, protein ... Read more
READER QUESTIONS:
Mix Panel Codes With Separate Tests
Question: Based on initial lab results indicating hypothyroidism, the physician ordered an... Read more
READER QUESTIONS:
Don't Flub Phlebotomy Coding
Question: When our lab provides a phlebotomist to draw blood, can we code separately for t... Read more
READER QUESTIONS:
Report Specific Glucose Diagnosis
Question: When our lab performs repeat glucose tests based on prior abnormal test results ... Read more
You Be the Coder:
Capture Each BAL Service
Question: When we receive a BAL specimen, what code should we use when we perform a cell c... Read more
More Edits Not Unlikely -- Don't Miss New MUEs
Learn what to expect from latest procedure limits CMS won't publish the list of Medically... Read more
MUEs Take Aim at Test Units -- Learn Targeted Codes
Latest -black box- edits limit Pap, bone marrow and more CMS won't publish the list of Me... Read more
Maximize Pay for Glycemic-Control Testing -- Here's How
Don't forget CLIA certification info  Fiction: Choosing 83036 or 83037 for hemoglobi... Read more
Clinch Payment for CLIA-Waived Tests
Keep up with quarterly updates to covered tests Don't miss the latest list of approved te... Read more
Reader Questions:
Know Cholesterol Screening and Panel Codes
Question: The lab receives an order for total cholesterol, HDL cholesterol, and triglyceri... Read more
Reader Questions:
Watch for Timely NPI Compliance
Question: Do pathologists need to have a National Provider Identifier by May 23 and use it... Read more
Reader Questions:
Distinguish 'For Tumor' From Neoplasm
Question: The surgeon submits a sigmoid colon resection and mesenteric lymph nodes for tum... Read more
Reader Questions:
Report Most Specific Lab Method
Question: Our lab runs an amplified-probe nucleic-acid Streptococcus group B detection tes... Read more
Reader Questions:
Which Code Takes Modifier 59?
Question: Should I always append modifier 59 to the lower-valued code of an NCCI edit pair... Read more
You Be the Coder:
Use 2 Codes for Separate Sessions
Question: The pathologist examined frozen sections and a skin biopsy that he diagnosed as ... Read more
Stay Ahead of the NCCI Curve With This Consultation Primer
Hint: You'll have to distinguish 80500 and 88321 code familiesIf you ever bill molecular d... Read more
NCCI Says:
Don't Double-Dip on Lab Methods -- or Else
Warning: Infectious agent detection includes nucleic acid stepsWhen your lab identifies or... Read more
Here's How to Use the Mystery FOBT Code
Remember, G0394 is not for screeningHere's a head-scratcher--Medicare cleaned up screening... Read more
Brush Up on Screening FOBT Basics
Don't limit Medicare screening to G codesBefore recent Medicare changes, you could remembe... Read more
READER QUESTIONS:
Distinguish Flow Cytometry From Total Counts
Question: When our lab measures absolute levels of B cells by flow cytometry, how should w... Read more
READER QUESTIONS:
'Can't Miss' Direction for Definitive Identification
Question: For microbiology, what is -definitive identification,- and how should I code for... Read more
READER QUESTIONS:
Reason for Genetic Screening Dictates Code
Question: If the lab performs screening for genetic carrier status of diseases such as cys... Read more
READER QUESTIONS:
Know Terminology for Skin Codes
Question: What is the proper CPT code when the pathologist examines an excised acrochordon... Read more
You Be the Coder:
Watch Method, Reason for Pap and HPV
Question: The physician ordered a screening Pap smear. Our lab used the Thin-Prep method... Read more
CPT 2007:
Small Word Change Means Big Money for Urine Cultures
Don't miss the chance to report 87088 per isolateWhen urine cultures resulted in more than... Read more
Microbiology Primer:
Don't Lose Identification Pay -- What You Need to Know Now
The culture is just the beginning when your lab provides information about infectious orga... Read more
Code 87804 -- Once or Twice? You Could Save an Extra $17
Learn these secrets for coding Quickvue, Binax productsYou should know that labs often tes... Read more
Capture Proper Flu Test Pay -- Here's How
Make sure you understand the lab method and sourceNot all influenza tests are created equa... Read more
READER QUESTIONS:
Check Out Medicare Diabetes Screening Rules
Question: What are the coverage rules for Medicare's diabetes screening coverage? Georgia ... Read more
READER QUESTIONS:
Mastectomy and Lymph Not Always 1 Specimen
Question: Our pathologist examines a partial mastectomy specimen and a sentinel lymph node... Read more
READER QUESTIONS:
Don't Unbundle Cholesterol Tests
Question: Our lab performs a test that measures HDL cholesterol subfraction (HDL2 and HDL3... Read more
READER QUESTIONS:
Use Different Codes for Different Needle Specimens
Question: From the pathology perspective, what is the difference between a fine needle asp... Read more
You Be the Coder:
Touch-Prep Count Starts Over
Question: The pathologist performed four touch preps on the margins of a lesion excision. ... Read more
Using New Microbiology Codes? Study the NCCI Edits
Rules limit new molecular diagnostics and consultation codes, too If your lab performs in... Read more
NCCI UPDATE ~ Surgical Pathology Includes Microscopy
Steer clear of 89060 with 88302-88309 -- you could be sending up a red flag Now that... Read more
Get Paid for Special Stains With Mohs -- Here's How
Learn exception to new NCCI edit pairs with 17311 and 17313 Bundling pathology and ... Read more
Listing Consultation With 17311 and 17313? Watch Out
The codes are new, but Mohs still includes frozen section exam CPT 2007 updated coding... Read more
READER QUESTION ~ BAL Depends on Method
Question: I-ve been told that I should code BAL specimens as 88112, but I-ve always used 8... Read more
READER QUESTION ~ Report Metabolites per Analyte
Question: We perform a lab test for estrogen metabolites using HPLC/MS. Specifically, we q... Read more
READER QUESTION ~ Blood BNP Shows Heart Failure
Question: What is the correct code for BNP, and what conditions show medical necessity for... Read more
READER QUESTION ~ Add-on Antibody Service
Question: Our pathologist examines a kidney biopsy, evaluating some permanent section slid... Read more
YOU BE THE CODER ~ Choose Most Specific Blood-Test Code
Question: How should we report a blood test for Interleukin 6? I can't find it listed anyw... Read more
CPT 2007 UPDATE ~ 'Simple' Change Clarifies Cytology Codes -- Our Experts Weigh In
Don't mistake 88106-88107 for 88112 Not all filtration methods are created equal, and you... Read more
Medically 'Unlikely' Edits Will Definitely Happen
Watch for numeric limits to Pap and PSA Beginning Jan. 1, you-ll have to contend with a n... Read more
NEWS BRIEF ~ Performing CLIA-Waived Tests? Update Your List Now
Don't miss new tests or new codes  for 2007 The current update for waived tests unde... Read more
Hold On to Test Payment -- Follow These ABN Guidelines
Missing signatures could mean a dip in your bottom line When an insurer won't cover a pat... Read more
READER QUESTION ~ Choose Code Based on Reason for Excision
Question: A patient had a partial mastectomy with cancer findings, including margins that ... Read more
READER QUESTION ~ Watch for IHC Unit of Service
Question: How should we code a breast biopsy specimen that the pathologist processes in th... Read more
READER QUESTION ~ Adenoids Stay Bundled
Question: A surgeon performs a tonsillectomy but submits the tonsils in separate container... Read more
READER QUESTION ~ Don't Start With Neoplasm Table
Question: When assigning diagnosis codes from the pathology report, I often have difficult... Read more
READER QUESTION ~ ICD-9 Shows Medical Necessity for NCDs
Question: How should we use the -Covered ICD-9 Codes- list in the National Coverage Determ... Read more
YOU BE THE CODER ~ Don't Miss Fibroid Exception
Question: When the pathologist examines a hysterectomy specimen for fibroids, should we co... Read more
CPT 2007 CLIP & SAVE:
Don't Miss Revisions in Immunology and Microbiology
Get ready for the new edition, which takes effect Jan. 1 If you-ve been wondering how you... Read more
Never Code 88331 With 88334? Not So Fast
Separate sites on single specimen justify code pair -- and an extra $51 Reporting in... Read more
QUICK QUIZ:
Test Your Frozen Section/Touch Prep Skills With These Vignettes
Code the scenarios, then compare your response to our experts- Think you understand w... Read more
CPT 2007 Clip and Save:
Don't Miss Revisions in Immunology and Microbiology
Get ready for the new edition, which takes effect Jan. 1If you-ve been wondering how you s... Read more
READER QUESTION:
Code Each Step for Urine Cultures
Question: When our lab performs a urine culture, how should we code if the culture is nega... Read more
READER QUESTION:
Report Each IHC
Question: Our pathologist performed a concentrated (cytospin) pleural fluid smear exam. Th... Read more
READER QUESTION:
Outside Consults Based on Accession
Question: We received slides and blocks from an outside institution for a consult on a pat... Read more
READER QUESTION:
Frozen Sections--Count Specimens First, Then Blocks
Question: How should we code the following case? Pathologist receives A) biopsy of right c... Read more
YOU BE THE CODER:
Beware of Mixing Flow Cytometry Codes
Question: I-m preparing to establish a flow cytometry panel that includes NK cells, B cell... Read more