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Pathology/Lab Coding Alert

Story 1:
Translate Endometrial Biopsy Diagnoses With 2 New Codes
Distinguish hormonal or pre-malignant hyperplasia with expanded 621.3. In with the new, b... Read more
Zero In On Nasal-Specimen Nuances With This Quick Quiz
Missing multiple 88304 specimens could cost your practice $125. Busting the polyps' "s" m... Read more
Did You Lose $125? Check Your Quiz Answers Here to Find Out
Make sure you captured every specimen and ancillary service. Check your answers to the na... Read more
Spotlight Known Condition -- Not 'Lab Exam' -- for ICD-9 Selection
Clear V72.6x hurdle with ICD-9, coverage guidelines. Adding five new ICD-9 2010 laborator... Read more
Capture Imprints and Frozens -- When You Can
Question: The pathology report for a colon biopsy states, "rapid imprints and frozen sect... Read more
Reader Question:
Step Up Your Coding for Each FNA Step
Question: Our pathologist often aspirates a breast lesion using a fine needle. When she e... Read more
Reader Question:
Cross-match Code Covers Care
Question: When our pathologist/hematologist consults for a difficult blood cross match, i... Read more
Reader Question:
Specimen Type Points to Cervical Diagnosis
Question: Our pathologist reports the following diagnosis for a diagnostic cervical Pap s... Read more
Reader Question:
Drug Screen Reason Drives Diagnosis Code Choice
Question: What is the proper ICD-9 code when the lab performs a urine drug test? Tennesse... Read more
You Be the Coder:
Pay Attention to Transfusion Reaction Index Change
Question: I heard that we would have a new ICD-9 code this year for transfusion reactions... Read more
Employ 5 Tips To Identify Proper Nasal Specimen Codes
Master unlisted tissues like 'septum' and 'turbinate' now. Get the code wrong for "sinus ... Read more
Don't Miss Extra Pay For Nasal Specimen Add-Ons
Watch for +88311-+88313. You know how to select the proper nasal specimen code, but ... Read more
Can't Locate an H. Pylori Lab Test Code? Two Clues Point the Way
Solve CLO test culture code dilemma and other mysteries. With numerous Helicobacter pylor... Read more
Match Test Methods, Specimen Sources to Codes Using This Guide
Don't search in vain through CPT to find the proper code for a Helicobacter pylori test. I... Read more
Reader Question:
Avoid 'Rule-Out Lyme Disease' Diagnosis Trap
Question: Our lab processes a blood specimen using a direct probe technique for a patient... Read more
Reader Question:
88220 Won't Stand Alone
Question: We didn't receive payment for an 88280 charge because we did not bill it with a... Read more
Reader Question:
Correction: V58.83 is Primary Diagnosis
Question: Which ICD-9 code(s) should we use when billing for a PT test to monitor Coumadi... Read more
Reader Question:
Distinguish Breast Specimens for Proper Pay
Question: How should we code the pathologist's exam of left and right breast tissue from ... Read more
Reader Question:
Focus on Fibroid Diagnosis
Question: When our pathologist diagnoses uterine fibroid tumors, what ICD-9 code should w... Read more
You Be the Coder:
Solve DOS/Add-On Code Dilemma
Question: We had a liver biopsy Medicare case dated April 4, 2009, and the pathologist re... Read more
CPT 2010 Preview:
Paid Per Drug Class for Test Kits? That's About to End
You'll get less pay for low complexity drug screen. This winter a pair of G codes may rep... Read more
5 Strategies for Superior PSA Pay
Let 'reason' distinguish procedure and diagnosis codes. Even if your lab performs lots of... Read more
Clip and Save Chart:
Welcome 15 New Specific Codes for Up-and-Coming Diagnostic Tests
Handy table lists new clinical laboratory test codes. From a marker for ovarian cancer... Read more
Precise ICD-9 Pick Shows PSA Medical Necessity
Capture additional $27 for diagnostic following screening test. From urinary symptoms to ... Read more
Focus on 59 for Dual Puncture Bone Marrow Extractions
Same site might make G code your payment key. If your pathologist procures both a bone ma... Read more
Reader Question:
Make Sure You Use the Same Date for Special Stains
Question: Our lab processed a paraffin block and prepared H&E slides from a skin biop... Read more
Reader Question:
Eliminate 80055 From Your Medicare Billing
Question: We recently billed an obstetrics panel for a patient on Medicare disability. Ou... Read more
Reader Question:
Susceptibility Rule: Choose 1
Question: We perform a susceptibility test for staphylococcus isolates using a Vitek anal... Read more
You be the coder:
Watch Interpretation Unit of Service
Question: Our lab performs a B-cell gene rearrangement test by PCR with a series of prime... Read more
Snag Lab Test Pay With Swine Flu Fast Facts Bill for tests that precede public health surveillance.
Bill for tests that precede public health surveillance. If you're one of the many labs pe... Read more
Differentiate Swine Flu Confirmatory Tests
Public health rules guide fee-exempt testing. Standard flu tests are not the end of the l... Read more
5 Rules Pinpoint Laboratory
Get the date right to ensure Medicare program compliance. You can't afford to get the dat... Read more
Easily Identify When Lab DOS Rules Apply to You
Hint: Global billing implicates pathology services. Can you ignore Medicare's laboratory ... Read more
You Can't Document Consultations Too Carefully
Question: We received a tissue block from another institution, and our pathologist state... Read more
Specific AFP/AFP-L3 Ensures Pay
Question: Our lab determined total AFP and the L3 fraction isoform for a patient with an ... Read more
Tread Carefully on Cytopathology Source
Question: When we prepare six or more slides from a fine needle aspiration specimen or ot... Read more
Capture Extra $17 for C. Diff Toxin A and Toxin B
Question: We've gotten denials when we bill 87324 x 2 for two EIA tests for C. diff toxin... Read more
You Be the Coder:
Don't Sell Yourself Short on Margin Exam
Question: Sometimes the surgeon submits a breast lumpectomy specimen while the patient is... Read more
ICD-9 Update:
Rev Up Your Pathologist's Cancer Coding Accuracy With 4 Changes
Merkel cell CA gets its own codes -- will you know where to look? If you stick with ... Read more
ICD-9 Update:
Your Non-Specific Transfusion Coding Hinges on Looking Here
Track data with these new poisoning codes, too. You can stop lumping multiple conditions ... Read more
Spotlight Don't Let New 'Lab Exam' Codes Sabotage Your Pay
Alert physicians to keep using condition codes. New, specific ICD-9 codes for "pre-op" an... Read more
4 Tips Build Your ICD-9 Know-How
Confused about ordering or final diagnosis? Look no further. Insurers base your payment o... Read more
News Brief :
Start Using New Swine Flu Code Oct. 1
Capture flu data with ICD-9 addendum. When your lab identifies a patient who tests positi... Read more
Reader Question:
Narrow Your Choices for 83912
Question: At the request of the treating physician, our pathologist provided an interpret... Read more
Reader Question:
Match Screening, Interpretation Pap Codes for Medicare Pay
Question: We're having problems with denials when we bill Medicare for a thin-prep screen... Read more
Reader Question:
Watch for Separate Slide Prep Charge
Question: Our cytology lab prepares slides for UroVysion FISH by liquid based preparation... Read more
Reader Question:
Know When Pathologists Should Revert to Ordering Diagnosis
Question: We received a mastectomy specimen based on a prior cancerous biopsy but find no... Read more
You Be the Coder :
Counting Won't Predict Proper Prostate Code
Question: Our pathologist received two containers from surgery, one identified as "right ... Read more
Scenarios TestYour Touch Prep Coding Skills
Focus on site to get the pay you deserve. When your pathologist per... Read more
3 Steps Take the Guesswork Out of Coding Screening Paps
Apply HCPCS Level II codes for Medicare reimbursement. How will you... Read more
Table 1:
Medicare Pap Screening Codes and CPT Crosswalk
The following table shows Medicare technical screening Pap codes and lists the corre... Read more
Spotlight Risk and Frequency to Garner Pap Pay
Capture annual screening opportunity with this V code. If your labs... Read more
Make HPV Screening Denials a Thing of the Past
Showing medical necessity means choosing the right V code. If youre using V72.31 (Rout... Read more
Decipher Nitrazine Test
Question: We received a vaginal fluid specimen for a Nitrazine smear. What is ... Read more
Don't Make These Urine Culture Mistakes
Question: The lab ran a urine culture that the physician ordered because the p... Read more
Zero In on Lipid Screening Guidelines
Question: Were having problems with Medicare payment for lipid screening. I th... Read more
Learn Ionized Calcium's Dirty Little Secret
Question: Weve been billing for the new basic metabolic panel (ionized calcium... Read more
You Be the Coder:
Omitting G0364 Could Stall Aspiration Pay
Question: When our pathologist performs a bone marrow aspiration and biopsy fo... Read more
3 Steps Launch Perfect In-Vivo Coding
Transcutaneous tests bridge lab/ER. The newest CPT lab category int... Read more
Same Test, Different Code? Choose 1
Consider new CCI edits your guide. Heads up: You have new restricti... Read more
Rethink Separate Microdissection Charge With Morphometric Analysis
Expect denials if you ignore new CCI 15.1 bundles. If your lab perf... Read more
Make Sure You're Ready -- Peer Ahead to ICD-10
Start planning now for staff training. If you hoped that the tempor... Read more
Guard Against 'Bad' ICD-9 With ABN
Question: When we receive an order for a lab test, do we need an ICD-9 code fr... Read more
Hone Strep Coding Skills
Question: What ICD-9 and CPT codes should we report for a negative strep test?... Read more
Payer Dictates Cytopathology Coding
Question: We received two direct-smear slides from a bronchial brushing along ... Read more
Beware Coding 'Rule Out' Diagnosis
Question: Our pathologist diagnosed a normal colon biopsy that the physician o... Read more
Match Pap Screening Tests or Lose Pay
Question: When our pathologist bills 88141 to interpret an abnormal liquid-bas... Read more
Identify Definitive Diagnosis
Question: We received an order for a screening lipid profile, but the ordering... Read more
You Be the Coder:
Containers or Cores -- Which Defines Prostate Specimen?
Question: If our pathologist receives needle core prostate biopsy specimens in... Read more
Clear These PT Coverage and Reporting Hurdles by Following 5 Guidelines
These rules let you capture allowed lab prothrombin time pay without breaking inclusion,... Read more
Zero In On Home Anticoagulation Monitoring
This checklist reveals if patient qualifies for using three G codes. Although you can't... Read more
Override FNA Edits While Avoiding 3 Pitfalls
Moneymaker: These traits -greenlight- breaking out cytology or consult. Just because Me... Read more
Clarify Special Stain Units
Question: When our pathologist performs three PAS stains, three Masson stains, and one J... Read more
Don't Double Blood Culture Codes
Question: Because the lab always collects blood specimens as a set of two bottles and re... Read more
Capture Separate LDL Opportunity
Question: Can we report a direct LDL test in addition to the calculated LDL that is part... Read more
Be Cautious of FOBT Units
Question: When we report a fecal occult blood test (FOBT) using three cards with patient... Read more
Don't Double-Dip AFP-L3
Question: When our lab runs an AFP-L3 serum test for liver cancer marker, how should we ... Read more
You Be the Coder:
Watch for Add-On Requirements
Question: Our lab received a toenail biopsy for a fungal exam. We performed a PAS stain ... Read more
Step-by-Step Guide to Flawless Diagnostic Pap Coding
Avoid 5 blunders that will sink your claims. With 15 CPT Pap test choices, you have ple... Read more
Chart These Diagnostic Pap ABCs:
Use reorganized list to halt your CPT numerical order confusion.
CPT lists cervical or vaginal cytology tests in an interrupted code series from 88141-88... Read more
Steer Clear of These POS Pitfalls
Make sure you-re getting the right payment for the right -place.- When the Office of In... Read more
Unravel This Flow Mystery
Question: We-ve started using modifier GD to override the MUE limits for flow cytometry ... Read more
Use ICD-9s With Certainty
Question: A patient presents to the physician office with a headache and severe vomiting... Read more
Frozen Block Can Fool You
Question: Our pathologist examined renal biopsy A with an H&E stain and renal biopsy... Read more
You Won't Find "Normal" Codes
Question: What ICD-9 code should we use to report a Pap test with -normal- results? Tex... Read more
Adding Arrays? -- Think Again
Question: We perform an HLA oligotyping test involving 630 probes in a DNA chip. Since t... Read more
You Be the Coder:
Catch Transformation Zone Distinction
Question: How should we use the new ICD-9 codes for -satisfactory smear but lacking tran... Read more
Mystery Solved:
Forget About G0394 for Colorectal Cancer
Eliminate -orphan- code to clean up FOBT claims. After three years of confusion about h... Read more
Beware Molecular Diagnostics 'Clarifications' -- $510 At Risk
-Unit of service- changes reimbursement for this CF assay. Although the AMA only intend... Read more
CCI 15.0:
Update Your Edit Pairs to Reflect CPT 2009
Hint: Many procedure bundles remain when code numbers change. CPT 2009 "moved" several ... Read more
Reader Questions:
See if Slide Preparation Stands Alone
Question: When our lab does Her-2/neu testing for a breast biopsy specimen sent to us by... Read more
Reader Questions:
Don't Miss Transformation Zone Nuance
Question: If the transformation zone is lacking in a Pap smear, does that necessarily me... Read more
Reader Questions:
Capture All Malaria Blood Smear Work
Question: Our lab prepares thick and thin blood smears with a Giemsa stain for a patient... Read more
Reader Questions:
Make Sure Stain is 'Special'
Question: We use a May-Grunwald-Giemsa stain on bone marrow specimens. Since the stain i... Read more
You Be the Coder:
Weigh In on Uterus Quandary
Question: We have Ob/Gyn clients who are asking for the weight of uterine specimens apar... Read more
CPT 2009 Rev Up Your Molecular Diagnostics Coding With These Tips
Use new -unit of service- definitions to capture every dollar. When you-re billing for ... Read more
'Method Trap' May Mislead Your Infectious Agent Coding
Unbundling molecular steps means too much pay -- and costly paybacks. Every time you se... Read more
HCPCS 2009 Avoid Overbilling:
Use New Codes for Prostate Saturation
Keep using 88305 for standard prostate biopsy or lose pay. You won't be getting $3,000 ... Read more
Untangle 'Saturation' Pricing That Affects Your Bottom Line
Get ready for G0416-G0419 with this handy chart Although you-ll see a big pay cut when ... Read more
Reader Questions:
Declare Medical Necessity for Smoother Sailing
Question: A physician's office sent a urine specimen to our lab for culture with the dia... Read more
Reader Questions:
Beware Quality Measure Billing
Question: During a needle core breast biopsy procedure, the surgeon asks our pathologist... Read more
Reader Questions:
Don't Miss Special Stain Fee
Question: Please explain why CCI bundles 88342 into 88323. If our pathologist consults o... Read more
You Be the Coder:
Capture HPV With Pap
Question: The pathologist diagnoses an abnormal Pap smear as ASCUS and performs an ISH t... Read more
Red Flag:
There's More to CPT 2009 Than New Codes
Make sure you know microbiology modifications that could save you $$$. Of course you ne... Read more
CPT 2009 Clip and Save:
Master Lab and Pathology Changes -- Start Today
Don't miss these new codes and notes for molecular diagnostics and more. Avoid denials ... Read more
Get Ready to Use Medicare's Streamlined ABN
Effective March 1, 2009, labs must use the new combined ABN/NEMB. You may have breathed... Read more
Reader Questions:
Clarify Opiate Coding With 83925
Question: We sometimes receive orders to test for multiple opiates -- maybe as many... Read more
Reader Questions:
Distinguish LEEP Specimens
Question: Is a cervical LEEP always a conization specimen? Can we code for two LEEPs if ... Read more
Reader Questions:
FNA Includes Consultation
Question: When our pathologist interprets an FNA, and then goes to the operating room to... Read more
Reader Questions:
Get Paid While Credentialing
Question: We-re adding a new pathologist to our practice who is not yet credentialed wit... Read more
You Be the Coder:
Know When Colon Is Separate
Question: Our pathologist examined a cecum with attached appendix and a separate gallbla... Read more