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
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...
How Labs Should Respond to the Change Healthcare Cyberattack
In the wake of the recent Change Healthcare cyberattack, independent lab owners and pathology groups are facing critical challenges. This overview aims to address common questions and concerns related to the attack’s impact on revenue cycles, compliance, and patient...
The importance of TC Modifiers in Pathology Professional Component Billing
By: Dyana Williams, RCM Client Engagement Manager As we continue to optimize our clients’ billing practices, it is crucial to ensure they have a clear understanding of the use of the TC (Technical Component) modifier, especially in situations where a pathology group...
The Power of Front-End Billing Edits: A Comparative Analysis of Claim Denials
By: Dyana Williams, Client Engagement Manager Understanding and addressing claim denial reasons is crucial for the financial stability of medical and pathology laboratories. As part of a recent case study, our RCM Solutions Team delved into the denial patterns of two...
Using Billing Data to Compare Commercial Lab Reimbursements
By: Dyana Williams, Client Engagement Manager, Lighthouse RCM Solutions Recently, a Lighthouse RCM Solutions client asked their billing vendor: What is our commercial reimbursement rate as a percentage of Medicare for CPT 88305? Utilizing our RCM Spotlight billing and...
CMS Targeting Errors on Drug Testing Claims Following TPE Review
Last year, we notified drug testing providers CMS was reviewing definitive and presumptive drug screening claims for errors and missing documentation as part of its Targeted Probe and Educate (TPE) program. Results for the WPS Region were published last week, showing...
Expanding Molecular PCR Services by Securing Nationwide Payer Contracts
Client: Infinite Genomics, LLC Fall 2023 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...
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. In this guide, we'll...
PAMA laboratory reimbursement cuts delayed through 2024
PAMA Reporting Delayed Again as Permanent Fix Sought Labs received a welcome reprieve from looming Clinical Lab Fee Schedule (CLFS) cuts this month when Protecting Access to Medicare Act (PAMA) reporting and associated test reimbursement reductions were delayed until...