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
Cuts for Labs, Pathology again proposed for 2024 Medicare Fee Schedule
The 2024 Medicare Physician Fee Schedule Proposed Rule released July 13 is already generating pushback from lab and pathology advocates, such at the College of American Pathologists (CAP), who contend these services and the physicians who provide them cannot sustain...
Incorrect Modifier Use Ties Up $200K in Lab Reimbursements
Our latest denial spotlight uncovers how RCM Spotlight, a powerful, AI-assisted tool for revenue cycle and denial management, optimized billing processes for one of our independent lab clients to unlock nearly $200,000 in reimbursement opportunities for previously...
New Digital Pathology Codes Introduced for 2024
The American Medical Association CPT Editorial Panel recently announced 30 new digital pathology add-on codes that will go into effect Jan. 1, 2024. According to the College of American Pathologists (CAP), the new digital pathology Category III CPT codes will be used...
The Significance of Medical Necessity and CO-50 Denials
By: Dyana Williams, Client Engagement Manager Medical necessity plays a pivotal role in determining whether a service or procedure will be covered by insurance. It refers to the requirement that a healthcare service must be appropriate and essential for the diagnosis...
Understanding the Keys to Diagnostic Test Reimbursement
In the complex landscape of laboratory and diagnostic test reimbursement, it can be difficult to understand how best to pursue coding and payment strategies for new tests when working across various government and private payers. One straightforward approach is to...
Why Mastering the Front End is Crucial to Lab RCM
By: Cassie Penn, Client Manager, Lighthouse Lab Services Laboratories have been in a whirlwind since the COVID pandemic started in 2019. Now that we have reached the end of the pandemic and the Public Health Emergency, laboratories need to work on tightening up their...
Watch for Shifts in COVID Testing Pay Ratio as Emergency Ends
By: Ann Lambrix, VP of RCM Consulting, Lighthouse Lab Services. About this article: Our monthly "RCM Industry Spotlight" series highlights timely findings from Lighthouse's proprietary RCM Spotlight denial management tool. If you'd like to learn more about how...
Reintroduction of SALSA Aims to Fix Lab PAMA Reporting
Independent laboratories have been pushed to the brink of financial instability in recent years due to the price cuts mandated by the Protecting Access to Medicare Act of 2014 (PAMA). However, as part of a yearslong effort to rectify the problematic pricing and...
Why Clinical Labs Must Prepare for Value-Based Care
As clinical laboratories continue to evolve to adapt to new innovations and approaches to patient care, one change the industry has been slow to fully embrace is the advent of value-based care and how it will impact laboratory medicine. Value-based care describes the...