A proven resource for avoiding 'revenue hazards' in the lab
What could go wrong with coding and billing for laboratory and pathology services? There are more "revenue hazards" than ever — new coding and billing issues targeted by the Recovery Audit Contractors (RACs); payments at risk due to the incorrect coding for molecular pathology services; and the potential for reduced payments under Protecting Access to Medicare Act (PAMA), to name a few. Make sure you have the right resource for reliable guidance through all the confusion and changes, from the uncertainties that come with advancing technologies to determining how to properly report new CPT®/HCPCS codes.
Features and Benefits
- Updated annually with the most current information:
- New, revised and deleted CPT/HCPCS codes for reporting laboratory, pathology and molecular pathology services
- Proprietary Laboratory Analyses (PLA) codes, plus guidance with how to correctly use PLA codes
- Proper use of CPT and/or G-codes for drugs of abuse testing
- Discussion of overbilling and use of modifier 59 for bacterial cultures (sensitivity and identification)
- Expanded guidance with modifier usage, protocol orders and point-of-care testing, and lab services for non-patients vs. hospital outpatients
- Step-by-step through coding and billing for laboratory and pathology services:
- Drug testing
- Therapeutic drug assays
- Molecular pathology
- Preventive services
- Blood banking
- Transfusion medicine
- And more!
- 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
- Coding flowcharts for at-a-glance guidance with selecting the correct CPT codes, along with examples of CPT codes to reinforce the correct choices
- Medicare payment information, including quick-reference tables with RVU and APC rates
- Special help with common areas of confusion and noncompliance, such as:
- Coding for diagnostic vs. preventive Pap smears
- Billing under a device code or as a lab-developed test
- Code changes and coverage limitations for clinical drug testing
- Coding for molecular pathology
CPT® is a registered trademark of the American Medical Association.
For certain MedLearn Publishing publications, you will see an 'AMA Royalty Fee' in your shopping cart. This charge covers the licensing fee MedLearn Publishing pays to the American Medical Association (AMA) for references to CPT® codes. The AMA owns the copyright for CPT codes.
When will my book ship? We will begin publishing our 2020 books immediately after the CMS releases the 2020 Final Rule. We anticipate this will be in early November, and estimate our books will begin shipping in December.