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Pathology/Lab Coding Alert

Clinical Lab:
Focus West Nile Virus Coding for Accurate Lab-Test Pay
Transmission route impacts diagnosis code. When your lab performs testing for possible We... Read more
PAMA Update:
Expect Radical Pay Changes for Clinical Lab Tests January 1
Unless CMS relents to universal industry condemnation. The preliminary pricing proposal i... Read more
Educate Lab Personnel on EMail Phishing Vulnerability
Don't be surprised that this old trick still works. You may think that only high-tech sol... Read more
Reader Question:
Follow Pap With HPV Reflex
Question: Our lab processed a screening Pap test and reported ASCUS findings, then re... Read more
Reader Question:
Use PHI Patient Access Form
Question: What guidance or tools could you give our lab to help us meet our obligatio... Read more
Reader Question:
Untangle Burn Case Report
Question: The lab performed an aerobic culture from a burn swab and presumptively ide... Read more
Reader Question:
Use QW for Waived Tests
Question: Please explain modifier QW and when we should use it in our lab. SuperCode... Read more
You Be the Coder:
Code This Endometrial Pathology Case
Question: Our pathologist examined an "endometrial specimen" and assigned a diagnosis... Read more
Anatomic Pathology:
Is Your LEEP Specimen 88305 or 88307?
3 tips can guide LEEP pathology reporting and coding. If cervical LEEP specimens give you... Read more
Convert 'Clock' to 'Quadrant' for Correct Breast Dx
Look up behavior first. When your pathologist evaluates a breast specimen, you don't have... Read more
Dodge OIG Focus on Lab Referral Rules
Distinguish Stark, AKS. The way your lab gets patient referrals could be the subject of a... Read more
DOS Guidance Sows Confusion
Stick with specimen acquisition. You know that the date of service (DOS) for clinical lab... Read more
Reader Question:
Evaluate Gene List for Proper Molecular Coding
Question: Our molecular lab performs a genomic sequence analysis panel for long QT sy... Read more
Reader Question:
Master ABN Modifiers For Your Lab
Question: When should our lab get a signed advance beneficiary notice (ABN), and how ... Read more
You Be the Coder:
Stick With Ovarian Cancer Dx
Question: The pathologist examined a specimen that was a 6.7 x 4.8 x 3.3 cm pelvic ma... Read more
CPT® 2018 Lab Preview:
Get Ready for Numerous Additional Molecular Codes
Look for novel RSV and Zika test codes, too. If you want the scoop on new 2018 clinical l... Read more
Part 1:
Coagulation Management: 3 Tips Show You How to Correctly Code PT Lab Tests
Don't skip this modifier - or you can expect claims denials. Monitoring PT/INR for patien... Read more
Part 2:
Coagulation Management: Follow Home PT/INR Monitoring Rules
Avoid G0250 frequency pitfall. In addition to ordering a Prothrombin Time (PT) lab test, ... Read more
Reader Question:
Follow Medicare's 60 Repayment Rule
Question: Is it true that we have only 60 days to return any overpayments to federal ... Read more
Reader Question:
Focus 83020 Testing
Question: Our lab is performing a new test using capillary electrophoresis to evaluat... Read more
You Be the Coder:
Capture Individual Specimens
Question: Two specimen containers arrived for diagnosis, the first containing tissue ... Read more
Hemicolectomy Evaluation:
Parse Your Pathology and Lab Reports to Execute Correct Crohn's Coding
Look for specific diagnostic statement. If your lab encounters the following specimens an... Read more
MACRA Update:
Embrace Help From MIPS Low-Volume Threshold Change
Small pathology practices find relief under QPP proposed rule. Maybe you’ve barely ... Read more
News You Can Use:
Anticipate MPFS Price Change for Your Pathology Services
Comment on CLFS revaluation process too. CMS recently released the proposed rule for the ... Read more
Reader Question:
Beware Unbundling 'Sample Validation'
Question: Can we bill together a urinalysis for pH and constituents (81001) and a uri... Read more
Reader Question:
Spotlight Accurate Strep-Test Ordering Dx
Question: Our lab received an order for a strep test for a patient with “recent... Read more
You Be the Coder:
Don't Lose Pay for 'Scant' Bone Marrow Aspirate
Question: Our pathologist examined a bone marrow aspirate and reported “scant c... Read more
ICD-10 2018:
Get Ready to Implement New Dx Codes October 1
Keep up-to-date for future quality pay. Allow our experts to unpack the latest ICD-10-CM ... Read more
Clear the 'Multiplex' Hurdle for Correct Code Selection
Make sure you know latest CCI instruction. If you’re still talking about “coc... Read more
3 Steps Keep BAA Compliance Costs Down
Get needed agreements on file in your lab. If one of your lab’s business associates... Read more
Reader Question:
Look to Signs and Symptoms for Lab Tests
Question: When we get orders for a clinical lab test, can we use “symptoms&rdqu... Read more
Reader Question:
Focus Genetic Counseling Following Molecular Testing
Question: As a molecular pathology lab, can we provide a service for genetic counseli... Read more
You Be the Coder:
'Exostosis' Definition Leads Code Choice
Question: The pathologist received a specimen from surgery for a heel bone spur. The ... Read more
Anatomic Pathology:
Study 4 Examples for Correct Soft Tissue Coding
Follow diagnosis-code lead. If you face a pathology report labeled “soft tissue mas... Read more
Minimize Edit-Pair Impact on Your Bottom Line
Uncover secrets of PTP modifiers and more. Confusion over Medicare’s National Corre... Read more
CCI Version 23.1:
Beware Pathology Consultation with Molecular Test Codes
Catch some interpretation bundles, too. CMS wants to make sure you know how NOT to report... Read more
Reader Question:
Dictate Breast Cancer Diagnosis to 7th Digit
Question: The pathologist examined a breast mass from a 42-year-old male. The surgica... Read more
Reader Question:
Mohs Means 1 Physician, 2 Services
Question: Our dermatopathologist removed a squamous cell carcinoma from the patient&r... Read more
Reader Question:
Learn This TC/26 Modifier Trick
Question: Our lab analyst performed a polarized light-microscopy exam of synovial flu... Read more
Reader Question:
Find Specific CF Test and Dx Codes
Question: Our lab received an order for a direct sputum acid-fast stain and culture i... Read more
You Be the Coder:
Focus Calculi Procedure and Dx Codes
Question: Our pathologist examined a specimen identified as a kidney stone and ordere... Read more
Anatomic Pathology:
Focus Your Spinal Cord Specimen Coding
Distinguish meninges from spinal cord. If your pathologists work downstream from a neuros... Read more
TB Testing:
Translate CDC Test Guidelines to Correct Coding
Distinguish tuberculosis disease from latent TB. With updated tuberculosis (TB) testing g... Read more
PAMA Update:
Grasp This Reprieve for Lab-Test Data Reporting
Now you have until May 31 to get the job done. If you’re an “applicable lab&r... Read more
Reader Question:
Spot Separate MI Blood Tests
Question: Our lab performed two troponin tests four hours apart, as well as a creatin... Read more
Reader Question:
Break Apart Immune Dysfunction Panel
Question: What codes should we use to report our lab’s work when the clinician ... Read more
Reader Question:
Get ABN for Molecular Tests
Question: We are an anatomic pathology lab and our pathologists will send cases to an... Read more
Reader Question:
Focus Hepatitis Coding in Pregnancy
Question: A physician ordered a hepatic function panel for a 32-week pregnant patient... Read more
Reader Question:
Protect Data on Mobile Devices
Question: Is it true that the Office for Civil Rights can collect damages for lost mo... Read more
You Be the Coder:
Capture Special Stains and Metastasis for Proper Coding
Question: Our pathologist examined a liver biopsy, evaluating H&E stained tissue ... Read more
Colorectal Cancer Screening:
Rundown CRC Test Options and Methods for Your Lab
Don’t overlook newer procedures and codes. If you’re stuck in the days of the... Read more
Follow Coverage Rules to Secure CRC Screening Pay
Master diagnosis and frequency limitations. Payers may approve many different testing met... Read more
Don't Double Dip for 'Multiplex' Tests
Add 87483 to your infectious agent detection arsenal. If you think you know all the oppor... Read more
Update Your Compliance Plan With These Tips
Don’t let your documents get “stale.” Maybe the answering machine and t... Read more
Reader Question:
Choose Screening Dx for Screening Test
Question: We’re using the new CPT® code for drug screening, 80305, instead ... Read more
Reader Question:
Focus Lynch Syndrome Coding With These Tips
Question: Our lab performs a full gene sequence analysis for MLH1 and finds mutations... Read more
You Be the Coder:
Understand FNA 'Evaluation Episode'
Question: Our pathologist received three FNA specimens from three different breast le... Read more
Avoid Pitfalls When Reporting Multiple Infectious Agent Antigens
Ensure compliance with policy manual update. When your lab bills codes from the range 872... Read more
Stop Losing Lab Pay Based on Z-Code Myths
Show medical necessity with ‘screening,’ ‘status,’ and more. If y... Read more
Clip And Save:
Use Common Z Codes for Your Lab Reporting and Pay
Impact your diagnosis coding with Table 1 rundown. Hopefully the preceding article helped... Read more
Reader Question:
Zero in on Trigone of Bladder Codes
Question: Our pathologist examined a “trigone of bladder biopsy” with fin... Read more
Reader Question:
Finish Your PAMA Lab Reporting This Month
Question: We are an “applicable lab” for reporting lab test payment data ... Read more
Reader Question:
Distinguish Definitive, Presumptive Drug Tests
Question: Our lab received an order for a drug confirmation test for alcohol, salicyl... Read more
You Be the Coder:
Solidify Your Hip Joint Code Choices
Question: The pathologist examined four bone fragments in a single container from the... Read more
Drug Testing 2017:
Avoid Pitfalls in CPT® and CMS Drug Screen Updates
Beware CLIA-waived confusion. If your lab performs drug testing, you might already be usi... Read more
MACRA Update:
FAQ's Target Quality Reporting For Your Pathology Practice
Move seamlessly from PQRS to MIPS As 2017 gets underway, quality reporting is here in a b... Read more
Quality Payment Program:
Know Which Measures Your Pathologists Can Turn To
Expect few changes since PQRS. If you don’t know these pathology “quality mea... Read more
Reader Question:
Watch for Microscopy Procedure with Lung Biopsy
Question: Our pathologist evaluated lung biopsy slides stained with toluidine blue us... Read more
Reader Question:
Focus Fetal Exam Coding
Question: The pathologist examined a fetus from a spontaneous abortion; the patient w... Read more
Reader Question:
Know Panel Code Limitations
Question: The lab received an order for blood levels of the following components: alb... Read more
Reader Question:
Classify Megacolon With C. diff
Question: The pathologist examined a colon resection and diagnosed dilated toxic colo... Read more
You Be the Coder:
Capture Nail Matrix Biopsy Work
Question: We received a toenail matrix biopsy for melanoma, which the pathologist exa... Read more
Medicare Payment 2017:
Glimpse These Physician Fee Schedule Final Rule Updates
Changes from proposed rule help pathologists. A slight Conversion Factor (CF) increase... Read more
Coding Quiz:
Test Yourself With 5 Pap Test Scenarios
Distinguish reason for repeat Pap. When your lab performs Pap tests, do you know the i... Read more
MPFS 2017:
Update Your Pay Expectations With This Chart
Evaluate your mix of services to estimate impact. If you want to evaluate how the 2017... Read more
Coding Answers:
Grade Your 5 Pap-Test Scenario Responses
Don’t confuse screening vs. diagnostic tests. After reading the questions on pag... Read more
Reader Question:
Margin Leads Breast Code Choice
Question: Our pathologist examines a breast excision and diagnoses “lobular c... Read more
Reader Question:
Tackle 'Cloud' Vs. 'Client Server' Issues
Question: We’re considering going to “cloud” storage for our Elec... Read more
Reader Question:
Check Diagnosis Before Assigning Uterus Exam Code
Question: For a pathology exam of a uterus specimen in which the pathologist diagno... Read more
You Be the Coder:
Focus EBV Lab Test Coding
Question: Our lab processed a serum specimen for a requested infectious mononucleos... Read more
CPT® 2017:
Notice Code Category Shift for Prostate Cancer Test
More lab tests, fewer biopsies may be in your future. With protocols for prostate canc... Read more
Prep for January Data Reporting to CDLT Payment System
Signing up may be half the battle. Once you know you’re an “applicable lab... Read more
Q/A Roundup:
Drill Down For More PAMA Guidance For Your Lab
Understand applicable labs, ADLTs, and more. If your head is still swimming with the w... Read more
Reader Question:
Learn 81528 Coverage Requirements
Question: Our lab performs the Cologuard test for colon cancer screening, but we&rs... Read more
Reader Question:
Use 26, Not PC for Professional Component
Question: If the pathologist examines a pathology case, such as an adrenal resectio... Read more
Reader Question:
Save This Medicare Acronym Primer
Question: Communications from our Medicare contractor are so full of “alphabe... Read more
You Be the Coder:
Access Genetic Testing Diagnosis Options
Question: With all the genetic testing options for cancers and germline mutations, ... Read more