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
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 2022 Local Coverage Determination (LCD) that significantlys impact reimbursement for these services.
IHC Reimbursement Under the Microscope: What Pathology Groups Need to Know
Payment and coverage for immunohistochemistry (IHC) stains are facing increased scrutiny from both commercial and government payers. For pathology groups and laboratories, this heightened attention has translated into several areas to watch.
How Clinical Labs Can Improve Payer Network Access and Leverage
For independent and small- to mid-sized reference labs/POLs, one reality remains consistent: laboratories fail for two primary reasons. Either they cannot get enough samples in the door, or they cannot get paid for the work they perform.
Molecular Test Reimbursement: MolDX, Z-Codes & Payer Reform
If you work in a clinical or molecular lab, you’re living this tension every day: advancements in testing keep moving forward, but reimbursement rules lag months or even years behind.
Keys to Adding a Laboratory to Your Gastroenterology Practice
Building a laboratory within a gastroenterology (GI) practice can be a strategic move to boost control over your samples and improve your standing with private payers, providing physicians with opportunities for increased efficiency and revenue.
Balancing Compliance, Risk, and Revenue in Toxicology Testing
For many labs, toxicology has long been a top target for payer audits. Reimbursement cuts and stricter “medical necessity” interpretations are raising denials, claw-backs, and scrutiny, especially around frequency of testing and documentation quality.
Expanding Molecular PCR Services by Securing Nationwide Payer Contracts
Client: Infinite Genomics, LLC Overview Infinite Genomics was formed as a molecular diagnostic laboratory in 2021. Although the lab is located in North Little Rock Arkansas, it intended to offer PCR services to providers across the nation. To put that plan...
Understanding and Navigating Medicare MUE, PTP Edits
As with most CMS initiatives, it can be difficult to keep pace with the constantly evolving list of MUEs, especially when considering CMS and other carriers reserve the right to maintain a list of unpublished MUEs that providers and their billers likely won’t know about until they receive a denial.
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.
