Understanding and Navigating Medicare MUE, PTP Edits
The Medicare National Correct Coding Initiative (NCCI) (also known as CCI) was installed to promote national correct coding methodologies and to control improper coding leading to payment. NCCI Procedure-to-Procedure (PTP) code pair edits are automated prepayment...
Pitfalls to Avoid When Using Diagnosis Z-Codes
Lighthouse billing and coding specialists have recently observed a rising trend of claim denials for laboratory services involving the Z00.00 diagnosis code. This code, which is used for general adult medical examinations without abnormal findings, often needs to be...
Guide: Navigating PCR Billing Challenges in MolDx Jurisdictions
00:00 1X Laboratories performing polymerase chain reaction (PCR)-based diagnostic testing continue to face significant billing and reimbursement challenges, particularly in regions covered by the Molecular Diagnostic Services Program (MolDx). As labs operating...
3 Things to Know When Billing for Genetic and Molecular Testing
As labs throughout the country continue to explore new revenue streams in the face of seemingly endless annual cuts from CMS and commercial payers, many are adding genetic testing and molecular diagnostics to their test menus. However, due to a patchwork of regional...
