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
Pitfalls to Avoid When Using Diagnosis Z-Codes
By: Tami Shaw, Client Manager, Lighthouse RCM Solutions 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...
Key Billing Considerations for Toxicology Labs: Documentation and Medical Necessity
By: Liset Sanchez, Client Manager, Lighthouse RCM Solutions A recent publication from Palmetto GBA highlights the fact that laboratory services are among the top service types found to make the highest number of billing errors. They categorize those billing errors...
Navigating ‘Excludes 1’ & ‘Excludes 2’ Denials in Medical Billing
By: Tami Shaw, Client Manager At Lighthouse Lab Services, we’re committed to providing our clients with the insights and best practices needed to navigate the complexities of Revenue Cycle Management (RCM). Lately, we’ve received several inquiries from clients...
New Novitas Process Set to Impact Pathology and Laboratory Claims
By: Billie Mildenberger, Director of Audit Services Note: Novitas announced this change will not take effect until Sept. 19, 2024. Starting Aug. 18th, 2024, Novitas will implement a process impacting newly effective molecular pathology and Proprietary Lab Analysis...
Effectively Navigating Medicare TPE Audits for Clinical Labs
By: Dyana Williams, Director, RCM Solutions Medicare's Targeted Probe and Educate (TPE) program is designed to identify and reduce improper payments, enhance compliance, and educate providers on proper billing practices. While TPE audits are intended to be educational...
7 New Payer Contracts Obtained for Full-Service Medical Lab
Overview The client is an independent medical laboratory located in the Southeast of the U.S. that has served its local community for almost seven years. It is a full-service lab including blood culture, toxicology, and molecular testing. RELATED CASE STUDY: Expanding...
Case Study: Payer Denying Lab Outreach Work Due to Policy Error
By: Beth Madden, Client Manager, Lighthouse RCM Solutions The Issue Our RCM Solutions Team often digs into denials that continually stem from the same payer in order to help our clients better understand what is creating a payment logjam while ensuring future claims...
What is MolDX and When Do I Need a Z-Code?
Information provided by Tami Shaw, Client Manager, Lighthouse Lab Services Palmetto and WPS delayed enforcement of the LCD highlighted in this article until May 17, 2022. The LCD highlighted in this article went into effect for CGS and Noridian on June 2, 2022....
Navigating Medical Necessity for PCR Testing
It's essential for referring providers considering large panel tests to grasp the nuances of Medicare National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) in order to effectively navigate medical documentation requirements. Without...