Pathology CPT Codes
Insights on CPT Codes
Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. Learn below the latest rules and regulations from our team of medical billing experts.
Read the latest updates on Pathology CPT codes
Medical Billing Audit Unlocks $20K in Claims After Cyberattack
As we look back at recent trends, 2024 may go down as the year of the cyberattack. In February of last year, the Change Healthcare breach made national headlines as the largest healthcare cyberattack in history, halting claims submission and disrupting payments across the country.
6 Tips for How to Get In Network with Insurance Companies
Has your lab or group encountered obstacles when trying to determine how to get in network with insurance companies who represent your patient population? If so, you’re not alone. Health insurance companies manage their provider networks in a variety of ways and under different strategies.
Guide: Navigating PCR Billing Challenges in MolDx Jurisdictions
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 in these areas…
What is MolDX and When Do I Need a Z-Code?
Laboratories performing infectious disease testing and billing Medicare Part B within a MolDX jurisdiction are subject to a new Local Coverage Determination (LCD) that stands to significantly impact reimbursement for these services.
Case Study: Using Billing Data to Bolster Lab Contract Negotiations
Overview A leading laboratory client was initially offered a reimbursement rate of 100% Medicare for their commercial policies. Given that commercial payors typically reimburse significantly higher than Medicare rates, accepting this offer would have left substantial...
The Cost of Cybersecurity Failures in Healthcare: Lessons from the Ascension Breach
By: Dyana Williams, Director, Lighthouse RCM Solutions The healthcare industry continues to face an increasing number of cybersecurity threats, and the fallout from these breaches can extend far beyond immediate downtime. The Ascension cyberattack in May 2024 serves...
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...
Managed Care Contracting: How Hospital Labs Can Improve Their Negotiating Approach
When it comes to managed care contracting, hospital laboratories face an increasingly complex landscape. Navigating these contracts effectively can make the difference between thriving financially and struggling to maintain operations. Understanding key contract...
Exploring Value-Based Care: Insights and Opportunities for Medical Labs
Value-based care represents a transformative shift in healthcare, prioritizing patient outcomes and cost efficiency over the traditional fee-for-service model. But despite its promise, transitioning to value-based care (VBC) is sometimes perceived as a challenge for...
