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Incorrect Modifier Use Ties Up $200K in Lab Reimbursements

Incorrect Modifier Use Ties Up $200K in Lab Reimbursements

by lighthouselab | Jul 12, 2023 | Billing & CPT Codes, Revenue Cycle Management, Industry Insights

Our latest denial spotlight uncovers how RCM Spotlight, a powerful, AI-assisted tool for revenue cycle and denial management, optimized billing processes for one of our independent lab clients to unlock nearly $200,000 in reimbursement opportunities for previously...
New Digital Pathology Codes Introduced for 2024

New Digital Pathology Codes Introduced for 2024

by Alex Mitchell | Jun 15, 2023 | Billing & CPT Codes, Revenue Cycle Management, Industry Insights

The American Medical Association CPT Editorial Panel recently announced 30 new digital pathology add-on codes that will go into effect Jan. 1, 2024. According to the College of American Pathologists (CAP), the new digital pathology Category III CPT codes will be used...
The Significance of Medical Necessity and CO-50 Denials

The Significance of Medical Necessity and CO-50 Denials

by lighthouselab | Jun 8, 2023 | Revenue Cycle Management, Industry Insights

By: Dyana Williams, Client Engagement Manager Medical necessity plays a pivotal role in determining whether a service or procedure will be covered by insurance. It refers to the requirement that a healthcare service must be appropriate and essential for the diagnosis...
Understanding the Keys to Diagnostic Test Reimbursement

Understanding the Keys to Diagnostic Test Reimbursement

by Alex Mitchell | Jun 8, 2023 | Revenue Cycle Management, Billing & CPT Codes, Industry Insights, Clinical Laboratory

In the complex landscape of laboratory and diagnostic test reimbursement, it can be difficult to understand how best to pursue coding and payment strategies for new tests when working across various government and private payers. One straightforward approach is to...
Why Mastering the Front End is Crucial to Lab RCM

Why Mastering the Front End is Crucial to Lab RCM

by lighthouselab | May 19, 2023 | Pathology Management, Revenue Cycle Management, Industry Insights, Clinical Laboratory

By: Cassie Penn, Client Manager, Lighthouse Lab Services Laboratories have been in a whirlwind since the COVID pandemic started in 2019. Now that we have reached the end of the pandemic and the Public Health Emergency, laboratories need to work on tightening up their...
Watch for Shifts in COVID Testing Pay Ratio as Emergency Ends

Watch for Shifts in COVID Testing Pay Ratio as Emergency Ends

by lighthouselab | May 15, 2023 | Clinical Laboratory, Billing & CPT Codes, Revenue Cycle Management, Industry Insights

By: Ann Lambrix, VP of RCM Consulting, Lighthouse Lab Services. About this article: Our monthly “RCM Industry Spotlight” series highlights timely findings from Lighthouse’s proprietary RCM Spotlight denial management tool. If you’d like to...
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