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Pathology/Lab Coding Alert

2016 Update:
Expect 2-Tier Drugs-of-Abuse Reporting for Medicare
Continue to ignore CPT® drug codes. The two proposed “G” codes for Med... Read more
Understand Screening vs. Confirmatory Testing
Grasp ‘definitive’ terminology, too. If your lab performs toxicology testi... Read more
HIPAA Compliance:
Bust These 4 PHI Disclosure Myths
Patients can request lab results. There’s such a thing as protecting “prot... Read more
Reader Question:
Learn Hemoglobin A1C Frequency Limitations
Question: We often get orders for hemoglobin A1C tests from physicians for patients... Read more
Reader Question:
Select Procedure Code for Soft-Tissue Mass
Question: Our pathologist received a specimen identified as a biopsy of a “so... Read more
Reader Question:
Change 'BPH' to 'Enlarged Prostate'
Question: The pathologist examines a prostate biopsy and diagnoses “benign pr... Read more
You Be the Coder:
Learn 'Unspecified' and 'Other Specified' ICD-10 Distinction
Question: We’ve observed that some codes we commonly used under ICD-9 don&rsq... Read more
CPT® 2016:
Preview Your Code Changes for Lab and Pathology With These 5 Highlights
Grasp changes for immunology, molecular studies, and more. The waiting is over &mdash... Read more
Drug Coding:
CPT® 2016 Pares Down Chromatography Choices
Changes compliment 2015 drug overhaul. By now, you should have adjusted to last years... Read more
ICD-10 Know How:
4 Steps Focus Neoplasm Coding
Look for clues in the pathology report. You’ve arrived — after years of pr... Read more
Neoplasm Coding:
Practice Your ICD-10 Cancer Coding With These Examples
Make sure you’re ready to use the tools for ICD-10 neoplasm coding that you read a... Read more
Reader Question:
Update Your Medicare Opt-Out Procedure
Question: Our pathology practice currently opts out of Medicare, and I heard that t... Read more
Reader Question:
Distinguish FNA, Cyst Aspiration
Question: The pathology report states that the specimen is an “FNA cyst aspir... Read more
Reader Question:
Follow Lab Method for Histoplasmosis Code
Question: The lab receives a blood specimen with a request for a test to “rul... Read more
You Be the Coder:
Count Bone Marrow Special Iron Stains
Question: The pathology report for a bone marrow case documents iron stains on bloc... Read more
Marshal Pay for Microscopic Chromosomal Analyses
Differentiate molecular test codes. The current focus on explosive growth in molecular... Read more
Distinguish 3 Forms of Trisomy 21
Focus on cytogenetic test results. Just one code (758.0, Down’s syndrome) w... Read more
PAMA Update:
Look into CLFS Pricing Reform Limbo
Guidelines miss June 30 mark. If you’ve been waiting with bated breath to learn... Read more
Reader questions:
Document More Detail for ICD-10 DCIS Diagnosis
Question: The pathology report indicates that the pathologist examined a breast bio... Read more
Reader questions:
Look to Mohs Codes for Dermatopathology
Question: The dermatopathologist removes a basal cell carcinoma from the central port... Read more
Reader questions:
Follow Carbon Isotope for Code Choice
Question: How should we code an H. pylori breath test? Georgia Subscriber Answe... Read more
You Be the Coder:
Clarify Bladder Biopsy vs. TUR Specimen
Question: The pathology report states that the specimen received is a bladder biops... Read more
Expect Just Two Medicare Drug Test Codes for 2016
Agency fears overpayment for drugs-of-abuse testing. Billing for Medicare-beneficiary ... Read more
2016® Lab Code Preview:
Watch For Continued Molecular Test Expansion
Check with CMS for final pricing decisions. You can get the scoop on what new 2016 cl... Read more
ICD-10 Implementation:
CMS Offers Relief -- No Claims Denials in First Year
Don’t relax your lab’s preparation. If you can at least list an ICD-10 cod... Read more
Reader Questions:
Update PSA Coding for ICD-10
Question: What diagnosis codes should we use for screening and diagnostic prostate ... Read more
Reader Questions:
Check Specimen for IHC Codes
Question: We are still dealing with getting paid for some IHC staining tests done i... Read more
Reader Questions:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Reader Questions:
Report ER Findings, Too
Question: When the pathologist completes a malignant breast cancer case and has per... Read more
Reader Questions:
Avoid Signs and Symptoms With Definitive Diagnosis
Question: When billing codes that fall under the physician fee schedule, should pat... Read more
You Be the Coder:
Beware Coverage Frequency Limitations
Question: A physician ordered a weekly hemoglobin A1C test to monitor a patient for... Read more
Decipher Unbundling Tools With This Lung Case
You can stick with modifier 59 for now. When you’re up against Medicare’s ... Read more
Location Drives Lung Cancer Diagnosis Changes
Laterality adds specificity. Coding for lung cancer won’t change too much when I... Read more
Drive Home Key ICD-9 to ICD-10 Changes for Your Pathology Practice
Avoid this one GEM trap. Maybe you’re ready to transition smoothly to ICD-10 sta... Read more
ICD-9 to ICD-10:
Take These 3 Preparation Steps
Transition doesn’t end on October 1. With a firm understanding of the ICD-9 to I... Read more
Reader Questions:
Check Payers for Crohn's Antibody Test Coverage
Question: Our lab performs antibody testing for ASCA and ANCA to establish a differ... Read more
Reader Questions:
Look for HPV Screening Coverage
Question: I’ve heard that Medicare has started to cover screening tests for H... Read more
Reader Questions:
Don't Split Combination Code
Question: Our lab performs an automated urinalysis and a urine microscopy exam, but... Read more
You Be the Coder:
Focus on Specimens, Stains, for FNA Case
Question: Please help with coding for the following thyroid case: Pathologist receives... Read more
G0472 to the Rescue for Hepatitis C Screening
Don’t report additional lab test code. When your lab performs a test for Hepatit... Read more
Support Medical Necessity for HCV Screening: Here's How
‘V’ codes move to ‘Z’ or ‘F’ codes for screening dia... Read more
Practice Management:
'Quality' Reporting - Get on Board or Lose Big Pay
Rewards and pay cuts hang in the balance for your pathology practice. PQRS, VBPM, and ... Read more
Reader Questions:
Avoid 'Self-Bundling'
Question: Our pathologist received a breast lumpectomy specimen, and a single axill... Read more
Reader Questions:
Use GZ as Last Resor
Question: Our lab performed a Pap test for a Medicare patient that exceeds the freq... Read more
Reader Questions:
Document Semen Analysis Service
Question:  Our lab performs a polymorphonuclear neutrophils test for semen. I think... Read more
You Be the Coder:
Capture Each BAL Examination Step
Question: Following a positive TB skin test, the physician performs a BAL and sends... Read more
Case Study:
Clear 3 Hurdles in Colon Cancer Case
Capture each specimen to boost your bottom line. When your pathologist examines tissue fr... Read more
Medicare Funding:
Say Goodbye to SGR Once and For All
Keep focus on ICD-10, too. You’ve waited with bated breath for the last time t... Read more
Check Out This Colon Polyp Coding Update
Document site to choose the proper code. You’ve read about ICD-10 coding for b... Read more
Prepare Your Lab For 5 HIPAA Trends in 2015
Expect state law to have a big impact. If you know you need to up your lab’s game f... Read more
Reader Questions:
Tie 'Request' to Consultation Code
Question: We received a paraffin block from an outside lab with a request to run repeat ... Read more
Reader Questions:
Match Lab Testing to CLIA License
Question:  Our physician office lab is CLIA waived, so if we perform 83009 and 8667... Read more
Reader Questions:
Don't Approximate ICD-10 Codes
Question: I have seen lots of great ICD-9 to ICD-10 crosswalks, but it seems like there ... Read more
You Be the Coder:
Let Payer and Purpose Lead Your Drug Test Coding Choice
Question: Please explain how I should code a drug-test order for a patient on prescripti... Read more
CPT® 2015:
4 Tips Decode New GSP Codes
Check coverage and await gapfill pay decision. If your molecular lab performs genetic ... Read more
GSP Payment:
Look to Gapfill Genomic Pricing for Next Year
Ask payers for reporting/payment instruction. You have 21 new CPT® codes for &ldqu... Read more
Expect Direct Crosswalk for Aortic Dissection
Specify thoracic or abdominal site Good news: Nothing changes but the number when you&... Read more
SGR Fix:
Manage Medicare Pay Cut Now
Senate may act after recess. It happened — April 1 came and went with no final C... Read more
ICD-10 Transition:
Use Testing Opportunities to Ensure You're Ready 
Watch for July application. If you think your lab is ready for ICD-10 implementation, ... Read more
Reader Questions:
Get Familiar With Sperm Toluidine Blue Assay
Question: The lab received a sperm specimen and a request for a Toluidine blue assa... Read more
Reader Questions:
Abide by Specimen Definition
Question: We’re trying to code a pathology report with the following informat... Read more
You Be the Coder:
Multiple FISH Probes Define 'Multiplex'
Question:Could you please clarify the meaning of “multiplex” in codes 88374 ... Read more
Ignore Massive CPT® 2015 Drug Coding Changes for Medicare
Choose from 28 new ‘G’ codes instead. Learning about the CPT® 2015 tox... Read more
F11.2__ Adds Manifestation to Opioid Dependence Codes
You won’t need separate manifestation codes anymore. You can forget vague dru... Read more
Modifier Focus:
Maneuver Modifier 90 Pitfalls to Bill Referred Lab Tests
Payer rules call the shots. If you want or need to bill for clinical lab tests that yo... Read more
Reader Question:
Ensure Encryption to Avoid HIPAA Breach
Question: If our lab uses unencrypted email to send a report with a patient’s p... Read more
Reader Question:
Unravel IHC Block, Specimen Question
Question: How many immunohistochemistry stains should you charge for this case: two brea... Read more
Reader Question:
Capture Pay for Distinct Prostate Stains
Question: Our lab performs qualitative EGR and PIN-4 stains on a single prostate co... Read more
You Be the Coder:
Brush Up on Specimen DOS Rules
Question: Could you please explain the CMS date of service policy, especially the i... Read more
CPT® 2015 Toxicology:
Part 1: Hone Drug Coding With New Sections, Drug Lists
Find changes all the way to the chemistry section. No kidding — the CPT® 201... Read more
Screening Drug Test Orders Use Many Diagnoses
Get ready for new options later this year. When your lab performs a screening drug tes... Read more
ICD-10 Prep
Remember that ICD-10 goes into effect Oct. 1 this year for Medicare, meaning that you&rs... Read more
CPT® 2015 Toxicology:
Part 2: Focus on Methods to Direct Your Drug Code Choice
Know your specimen source, too. New CPT® sections and new drug lists that you read... Read more
Physician Fee Schedule:
Follow Changing Payment Trail for Your Lab
The RVUs aren’t all you need to observe. As it turns out, things weren’t s... Read more
Reader Question:
Check for 'Repeat' or 'Bundle' Modifiers
Question: A physician ordered basic metabolic panel 80048 for a patient, and later ... Read more
Reader Question:
Distinguish Sperm Motility, Viability
Question: How should we code a sperm viability test known as an Eosin Y test? Is th... Read more
You Be the Coder:
Expand Keratoderma Choices in ICD-10
Question: Our pathologist received a skin specimen and wrote the diagnosis as &ldqu... Read more
2015 Medicare Pay:
See How Your Procedures Stack Up with PFS Winners, Losers
Expect more for pathology consultation. Depending on which codes represent high-volume... Read more
Final Rule:
Beware Potential 'Ides of March' Pay Cut
Only an act of Congress can save the day. You might be experiencing little change in M... Read more
C64.1_ Chooses Sides for Renal Tumors
Learn ICD-9 189.x crosswalks. Just two codes describe kidney tumors and renal-pelvis t... Read more
Lab Management:
Solidify Your Compliance Plan in 2015 With These OIG Tips
Take 7 steps now to meet ACA standards. Making sure your compliance plan is in place s... Read more
Reader Question:
Check Age, Conditions, for HCV Screening
Question: A physician ordered a hepatitis C screening test for a Medicare patient w... Read more
Reader Question:
Don't Prioritize Mass of Uterus
Question: I’ve heard that the mass of a uterus is important for choosing the ... Read more
Reader Question:
85610 Works for Coumadin Monitoring
Question: A patient with deep venous thrombosis (DVT) is on Coumadin for blood thin... Read more
You Be the Coder:
Carefully Document Stages for Modified Mohs
Question: Please explain if we should use Mohs codes for the following case, or if ... Read more
Physician Fee Schedule 2015:
Revamp Prostate Biopsy Coding -- Again
G0416 alone could hurt your bottom line. CMS thinks your pathologist should get $227 l... Read more
PSA Fundamentals:
G0103 or 84153: Avoid Coding Missteps With By Knowing Reason for Test
Match diagnosis code to procedure code. When your lab gets a specimen with an order for t... Read more
Follow the BPH Disappearing Act
You won’t find the term in the new diagnosis code set. If you can’t find t... Read more
Diagnosis Coding:
Follow These 3 Tips to Prepare for ICD-10
Zero in on common codes your lab uses. If you don’t want a rude awakening next O... Read more
Reader Question:
Use Interpretation Option for Certain Lab Tests
Question: When our pathologist receives a request for interpretation of a serum pro... Read more
Reader Question:
Specify Source for KOH Test
Question: Our lab received a skin scraping with a request to test for suspected sca... Read more
Reader Question:
88344 Fills Multiplex IHC Need
Question: How should we report our PIN4 triple stain under the revised IHC codes in... Read more
You Be the Coder:
Catch Up to Drug Test Code Changes
Question: I know the drug screen codes change in the latest CPT® update —... Read more