Coding Essentials for Laboratories-eBook
A renowned resource for streamlined coding efficiency and effective payment outcomes
As healthcare facilities face ongoing challenges, you need more than a guide to laboratory coding and billing. Mounting complexity, confusing new rules, and continued reductions in reimbursements require a comprehensive solution — this is exactly what you get with our Coding Essentials for Laboratories.
Did you know that some of the new PLA codes coincide with Category I CPT® codes, increasing the potential for mistakes and payment denials? Are you aware of the ramped-up scrutiny by payers looking for noncompliant practices, such as stacking CPT codes for multi-gene NGS panels? Likewise, Recovery Audit Contractors (RACs) could target some laboratory tests for proof of documentation to support medical necessity. With over twenty years of nationally recognized expertise, you can trust that we will deliver the latest guidance for correct reporting.
Unlock a time-trusted resource to guide you quickly to the correct codes for laboratory and pathology services.
Features and Benefits
Explanations and practical application of code changes and any pertinent policy updates
Experience enhanced coding instruction for assignment of Molecular Pathology targeted gene CPT and NGS panel CPT
Guidance for Proprietary Laboratory Analyses (PLA) codes; covers the expansion of PLA codes that appear to match Category I CPT codes — a scenario with a high risk for confusion, miscoding and claim denials
Guidance with coding instruction contained in the latest NCCI Policy narrative that provides a foundation for claim denials as well as payer audits
Scenarios where clinical pathology consultations may impact documentation and coding of laboratory procedures
Updated payment information
Our experts address common questions, concerns and problem areas:
Coding for diagnostic vs. preventive Pap smears
Coverage limitations that are increasing claim denials
Coding for molecular pathology
Proper use of modifiers for billing of laboratory and pathology procedures
Clear, step-by-step guidance through the tasks you perform every day:
Coding and billing for laboratory and pathology services:
Drug testing
Therapeutic drug assays
Molecular pathology
Chemistry
Microbiology
Preventive services
Hematology
Immunology
Transfusion medicine
Cytogenetics
Histology
And more
A proven quick-reference approach for busy professionals:
Coding flowcharts for at-a-glance guidance with selecting the correct CPT codes, along with examples of CPT codes to reinforce the correct choices
Each section includes:
Explanations of services and the intent of each
CPT/HCPCS codes and descriptions
Sample chargemasters
Coding and billing tips
Visual flow charts
Medicare payment information, including quick-reference tables with RVU and APC rates
Looking for more valuable coding education and news? Check out our Laboratory All-Access Pass for a full range of comprehensive educational resources that provide the best protection for your bottom line.