Much more than a laboratory coding guide: A complete solution to tackle the challenges wrecking your revenues
During these challenging times, 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
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) are targeting some laboratory tests for proof of documentation to support medical necessity. In addition, with the evolving pandemic, several new COVID-19 codes now exist that impact your laboratory services. You can trust that we will deliver the latest guidance for correct reporting.
Coding Essentials for Laboratories, our experts will help you steer clear of these and many other potential pitfalls, you can count on this time-trusted resource to guide you quickly to the correct codes for laboratory and pathology services.
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Features and Benefits
Updated and expanded content, including:
- Explanations and practical application of code changes
- Enhanced coding instruction for assignment of Molecular Pathology targeted gene CPT and NGS panel CPT
- Expanded 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
- Preventive services
- Transfusion medicine
- 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