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Pathology/Lab Coding Alert

CPT® 2019:
Embrace New FNA Extraction 'Guidance-Specific' Codes
Evaluation coding stays the same. When your pathologist extracts a fine needle aspiration... Read more
ICD-10-CM Quiz:
Tackle Diagnosis Coding for This GIST Case
Consider “behavior” to pick the right code. Test your diagnosis-coding prowess for th... Read more
ICD-10 CM Answers:
Check Your GIST-Case Diagnosis Code
Know ‘sarcoma' behavior. The short answer to this coding quiz is: C49.A3 (Gastrointesti... Read more
5 Tips Dodge Denials for Signature Errors
Avoid this common CERT pitfall. Perfect CPT® and ICD-10-CM coding might not be enough to... Read more
Reader Question:
Match Panel-Code Test List
Question: Our lab received an order for blood electrolytes potassium, sodium, total calciu... Read more
Reader Question:
Look for Fee Schedule Updates
Question: What conversion factor and program changes should I expect from the 2019 Medicar... Read more
Reader Question:
Monitor Procedure-Code Deletion Date
Question: We had a case that involved a procedure performed in late December that we did n... Read more
You Be the Coder:
See How Diagnosis and Bundling Impact Ovarian Case
Question: The pathologist evaluates a left-salpingo-oophorectomy specimen that the surgeon... Read more
CPT® 2019:
Update Chemistry Section with Direct-Measure Cholesterol Code
Catch new code for DHT, too. If your lab sometimes performs direct-measure tests for lipo... Read more
2019 Physician Fee Schedule:
Reap Rewards for IHC 88360-88361 Correct Coding
Hit the payday jackpot for technical component. The proposed 2019 Medicare Physician Fee ... Read more
Disaster Claims:
Focus Lab-Test Coding for Hurricane Florence Victims
Look for Medicare waivers and more. If you're a lab operating in the middle of a disaster... Read more
Reader Question:
Mohs Requires 1 Physician, 2 Procedures
Question: Our hospital lab has an arrangement with a local dermatologist to perform tissue... Read more
Reader Question:
Strep Group Dictates PCR Test Codes
Question: How should we report the service when our lab tests for Strep group A and group ... Read more
Reader Question:
Honor Patient PHI Request
Question: Do you have any advice to help us protect our patients' health information, if t... Read more
You Be the Coder:
Distinguish 'Separate' or 'Repeat' Test Modifiers
Question: When should we use modifier 91 instead of modifier 59?   Kentucky Sub... Read more
CPT® 2019 for Labs:
Preview Numerous PLA and Tier 1 Molecular Pathology Codes
Update some chemistry options, too. You need the scoop on 2019 clinical laboratory CPT® ... Read more
ICD-10-CM 2019:
Master New Infection Code Options for Wound, Appendix, Gallbladder
Remember the ‘X' placeholder. If you code for a pathology practice or clinical laborato... Read more
Practice Management:
Get the Scoop on Medicare Facts You Need to Know
Pathologists may choose to participate. Whether pathologists in your practice are new or ... Read more
Reader Question:
Check PLA Codes for Lab Tests
Question: Our lab is performing a new presumptive drug-screening test, typically for 10 dr... Read more
Reader Question:
Follow HIPAA Beyond the Grave
Question: Is our lab required to maintain a patient's private health information after the... Read more
Reader Question:
Beware HbA1c Frequency Guidelines
Question: We have a clinician who orders HbA1C testing every month for every diabetes pati... Read more
Reader Question:
Recognize Medicare Participation Levels
Question: If our pathologist is non-participating with Medicare, I thought that meant he c... Read more
You Be the Coder:
Get Breast Case from Procedure to Diagnosis
Question: For a 31-year-old female patient, our pathologist examined a breast lumpectomy c... Read more
ICD-10-CM Update:
Mark Changes for Coding Neoplasms, Metabolic Disorders, and More
Turn to op report for tumor site. As a pathology or lab coder, maybe you've sometimes wis... Read more
ICD-10-CM 2019:
Don't Miss 'Upper,' 'Lower' Eyelid Distinction
More than 40 new codes specify eyelid cancer. You read about the following new eyelid seb... Read more
Anatomic Pathology:
Leap Across Lymph-Node Coding Pitfalls in 5 Steps
Identify biopsy, resection, or bundled. Missing a lymph-node-resection exam could cost yo... Read more
Reader Question:
Watch the Calendar or Lose Pay
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
Reader Question:
Consider Gestational Age of Fetal Specimen
Question: A case involved the pathologist performing microscopic exam of a spontaneous abo... Read more
Reader Question:
Recognize 'Scalp,' 'Forehead' Dividing Line
Question: Should I use C4A.39 for Merkel cell carcinoma found only on the scalp, since C4A... Read more
You Be the Coder:
Capture 2 Parts of CTC Service
Question: How should we report the lab analysis and pathologist interpretation for a blood... Read more
Clinical Lab:
Obey Rules and Restrictions to Get Thyroid-Test Claims Paid
Ensure medical necessity for coverage. If your lab performs blood tests for thyroid funct... Read more
Wound Infection:
Master Pressure Ulcer Culture and Dx Coding
Don't miss tips on site and stage. When a clinician suspects an infection in a decubitus ... Read more
Steer Clear of OIG Action on Lab-Test Fraud
High costs and usage spur fed oversight. The 25 most-frequently ordered lab tests are und... Read more
Reader Question:
Learn New QPP Lingo
Question: I've recently heard the term “promoting interoperability” regarding the QPP ... Read more
Reader Question:
Tier 1 May Include Additional Variants
Question: We're providing an NRAS molecular test that yields results for multiple variants... Read more
Reader Question:
Show Signs and Symptoms Their Place
Question: Our pathologists frequently get specimens from physicians with reports that list... Read more
You Be the Coder:
Provide Antibody Info for 86255 Payment
Question: We received a denial for 86255 stating that we needed to provide documentation o... Read more
Pathology Consultation:
Break 3 Intraoperative-Consult Myths
Check out +88334 restrictions. Serious pitfalls greet you on the road to coding your path... Read more
Master Neoplasm Coding With Documentation, Definition, Deduction
Never make a guess for code assignment. When you look at the ICD-10-CM neoplasm table, yo... Read more
Follow 4 Tips to Keep Feds Away
Watch for medical necessity and more. You can fend off fraud and abuse accusations for yo... Read more
Reader Question:
Say Yes to MPO and CRP
Question: We have a cardiology client who orders serum CRP and MPO follow-up testing for p... Read more
Reader Question:
Use Pathologist's Diagnosis for Code Selection
Question: The pathologist examined a resection from a patient's left forearm that the surg... Read more
Reader Question:
Understand HbA1C Frequency Limits and Fee Schedule Rates
Question: Our lab performs monthly HbA1C testing for several patients ordered by one speci... Read more
Reader Question:
Don't Overstate or Understate Known Diagnosis
Question: The pathologist examined a fine-needle aspiration from the spleen of a patient d... Read more
You Be the Coder:
Bill +88311 With Primary Service Code
Question: During a chart audit, we were told that a specific case did not support billing ... Read more
CPT® 2018:
See How PLA Options Stir the Drug-Test Coding Pot
Recall presumptive, definitive difference and hierarchy. At first glance, you might think... Read more
Drug Testing:
Abide by Drug-Test Performance Parameters
Frequency and validity could trip you up. When your lab performs drug tests, you must fol... Read more
See How Medicare Texting Guidance Impacts Your Lab
Learn different rules for orders and results. When physicians order tests from your lab, ... Read more
Reader Question:
Focus Vitamin D Coding
Question: A physician ordered a test for serum Calcidiol D2 and D3, which our lab performe... Read more
Reader Question:
Take Heed of FNA Smear Exam Bundles
Question: Our pathologist evaluated a direct FNA specimen smear for diagnosis, then furthe... Read more
Reader Question:
Turn to Specific Urine Cytology FISH Code
Question: To monitor bladder cancer patients for possible recurrence by detecting possible... Read more
Reader Question:
Classify AIDS, HIV in ICD-10-CM
Question: How do I know when to code for AIDS (B20), not HIV (Z21)? SuperCoder Subscriber... Read more
You Be the Coder:
Capture Each Part of Renal Case
Question: Our pathologist was called to the operating room to evaluate a kidney biopsy spe... Read more
Proprietary Tests:
Greet 10 New PLA Codes for Q2, 2018
AMA assigns codes for Borrelia tests and more. Even if you're just getting the hang of th... Read more
Get Dx Coding Right for Urine Testing Medical Necessity
Target symptoms, site, condition, and more. Urinalysis and urine culture are commonly-ord... Read more
Heed Enforcement Warnings for Security Rule Compliance
Put physical and virtual access on lockdown. Maybe you've avoided HIPAA enforcement actio... Read more
Reader Question:
Grasp This IHC Coding Riddle
Question: Our pathologist examined a breast biopsy and evaluated stained slides for ER, PR... Read more
Reader Question:
Distinguish Influenza Strains for Multiple 87400 Units
Question: Our lab performs a multi-step enzyme immunoassay test for influenza A or B antig... Read more
Reader Question:
Expect Denials for Year-Old Claims
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
You Be the Coder:
Know What's Bundled with Bladder Specimen
Question: I'm coding a pathology report that describes examination of a cystectomy specime... Read more
CCI 24.0:
Get On Board With Massive Edits For Your Lab
Keep claims-filing rules straight for bundled codes. CPT® 2018 brought you lots of new l... Read more
CCI Basics:
Master Bundling Edits With Resources and Documentation
Zero in on your payer's expectations. You already know that Medicare's Correct Coding Ini... Read more
Outpatient Billing:
Take Advantage of 14-Day Rule Change
Bill directly for molecular tests. If you bill for molecular or certain other tests, Jan.... Read more
Reader Question:
Capture Each Step for Urine Culture
Question: Our lab ran a urine culture for a nursing home patient with an indwelling cathet... Read more
Reader Question:
Get Used to ICD-10
Question: I often find myself coding ICD-9 in my head and then using a tool to "translate"... Read more
Reader Question:
'When' and 'Where' Can Sidetrack Appeals
Question: We're having trouble with our appeals and redetermi­nation requests, which seem... Read more
Reader Question:
Follow Payer Expectation for Multiple Test Modifier
Question: A clinician submitted four blood-gas samples taken throughout the day for a sing... Read more
You Be the Coder:
Grasp Details for Accurate Uterine Fibroid Coding
Question: Our pathologist received two very large fibroid specimens in a single container ... Read more
CPT® 2018:
Transform Bone Marrow Reporting With New, Revised Codes
Pay heed to new CCI instruction, too. When you report your pathologist's bone marrow case... Read more
Sharpen Your HIV/AIDS Coding With this Quiz
Patient welfare and medical necessity are at stake. Maybe your lab is reporting results r... Read more
ICD-10 Coding Quiz:
Compare Your Answers to the Experts'
Don't give mistaken AIDS diagnosis. Making errors when reporting human immunodeficiency v... Read more
Reader Question:
Check Out Endometrial Hyperplasia Details
Question: I've been coding endometrial hyperplasia as N85.0, but a coder friend tells me t... Read more
Reader Question:
Use ABN Modifier for Non-Covered Flow Cytometry
Question: We recently had flow cytometry charges denied by Medicare for "diagnosis not med... Read more
Reader Question:
Don't Unbundle Alcian Blue/PAS
Question: What's the correct way to code an Alcian Blue/PAS stain to rule out Barrett's Es... Read more
Reader Question:
Forget Professional Component DOS Instruction
Question: I heard that Medicare issued a memo that we must bill the pathologist's professi... Read more
You Be the Coder:
Avoid Molecular Pathology Modifier Mix-Up
Question: We've recently started billing molecular pathology cases for pathologists. There... Read more
Clinical Lab:
Grasp Final CLFS Pricing Details for Your Lab
See exceptions to weighted-median valuation. Brace for payment reductions to about three ... Read more
Check Out New Code Pricing and More
Learn how ADLTs are different. The vast majority of codes paid on the Clinical Laboratory... Read more
CPT® 2018:
Greet New Way to Capture INR Monitoring
Change involves code additions and deletions. If your lab/pathologist is involved in anti... Read more
Master Clean Claims with Targeted Queries
Know when to ask for clarification. Sometimes you face a pathology report that seems to c... Read more
Reader Question:
Medical Necessity Can Trump CCI
Question: Our physician office lab performed rapid strep and rapid influenza tests that th... Read more
Reader Question:
Determine Reason for Lead Test
Question: A physician ordered a lead test as part of a pre-adoption examination for a 3-ye... Read more
You Be the Coder:
Choose Specific Colon Polyp Code
Question: We are trying to assign a diagnosis code for a specimen that the pathology repor... Read more
CPT® 2018:
Update New Category III Code Options for Your Lab
See how 0500T changes HPV coding, and more. An emerging technology for cadaver donor lung... Read more
CPT® 2018:
Explore 3 New Prostate Test Code Alternatives
MAAAs focus cancer risk assessment. Ever since the U.S. Preventive Services Task Force (U... Read more
Stem Cell Transplant:
Report Every Harvest Step to Capture Full Pay
Avoid bundling pitfalls that sabotage reimbursement. Billing for a pathologist with a hem... Read more
Reader Question:
Round Up Codes for This Pap Scenario
Question: We received a request for a Pap test six months following a prior Pap for the sa... Read more
Reader Question:
Identify Symptoms for Drug Screen Testing
Question: We're a physician office lab, and we had one of our doctors order a drug "screen... Read more
Reader Question:
Include All 80061 Components
Question: Our lab has a physician client who routinely orders total cholesterol and trigly... Read more
You Be the Coder:
Clarify Prostate 'Needle' Specimen
Question: I have a pathology report in which the "specimen" line states "prostate needle."... Read more