| Be proactive in protecting your revenue stream
Dollars are “slipping through the cracks” for many providers of pathology services. That’s why you can’t afford to be without Coding Essentials for Pathology Services. This easy-to-use handbook will help you avoid under-coding, billing errors and other issues that lead to missed revenue opportunities, while keeping you in compliance with government rules. Highlights:
- Focuses on the technical components of procedure coding and billing for pathology services
- Easy-to-grasp overview of Medicare payment, along with quick-reference APC tables
- How reimbursements are affected by specific coding and billing practices
- Chargemaster review and validation tactics
- Coding and billing strategies for typical and less common services, supplemented with billing tips, CPT®/HCPCS codes and descriptions, and visual reference tools
- Pathology-specific appendices containing payment tables, NCCI edits and excerpts from the Medicare Claims Processing Manual
Findings from MedLearn consulting experts
MedLearn consulting experts speak from their real-world experiences regarding the potential benefits of Coding Essentials for Pathology Services to healthcare organizations:
Revenue “black holes” — “Bone marrow studies, fine needle aspirations and other complex procedures are among the top money losers for laboratories. Over the years, we’ve seen a shift in who’s delivering these pathology services, but coding practices have not kept up with official guidelines. Hospitals can use this book as an audit tool to make sure all responsible parties, including their physician partners, are following the rules.”
Omission costs $90,000 — “One hospital client discovered an under-billing error that added up to almost $90,000 in annual net ervenue. The hospital contracted with a pathology group, which was significantly under-reporting codes for bone marrow studies on invoices sent to the hospital. Instances like this demonstrate the value of hospitals knowing what the rules are when they deal with their outsource partners.”
To bill or not to bill — “One of the biggest areas of confusion for laboratories is whether or not they may bill for the technical or professional component of a service. This book lays it out clearly and concisely using tables that break down payment rules for pathology services.”
Pathologist under-coding — “Many pathologists routinely under report for common procedures, such as biopsies. For example, they may take 10 tissue samples referred for separate evaluation. The pathologists examine each one, yet they only report examinations of the five specimens with positive malignant findings. By being aware of these omissions and understanding why they may bill for all services rendered, laboratory managers and pathology directors can knowledgeably discuss under reporting with their physician partners and initiate corrective action on the front end.”
CPT is a registered trademark of the American Medical Association
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