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
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…
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...
The Benefits of Lab Billing Consulting Services
Effective billing processes are central to the smooth operation of any laboratory. However, laboratory managers face complex challenges daily, with an increasing volume of claims and a matrix of rules that govern healthcare billing. Fortunately, lab billing consulting...
2025 CPT Code Changes for Pathology
Analysis provided by: Billie Mildenberger, Director of Audit Services, Lighthouse RCM Solutions Starting Jan. 1, 2025, there are 9 revisions, 114 additions, and 14 deletions for Pathology and Lab CPT codes. Many of these changes are to PLA (Proprietary Laboratory...
Key Considerations When Adding Digital Pathology
Digital pathology is rapidly transforming the field of diagnostic medicine, offering laboratories exciting opportunities to enhance workflow efficiency, patient outcomes, and collaboration. While the technology is promising, adopting it requires careful planning and...
