Identify and prevent common issues with laboratory claims
As you know, time is a limited commodity for busy laboratories. Coordinating all the applicable information that links testing methods to correct CPT®/HCPCS code selection can take hours out of multiple schedules due to the many layers of regulations, coding guidelines and coverage limitations that impact compliance and reimbursement. You're not alone in the challenge to balance health sciences and financial management.
Laboratory claim denials and edits are typically #1 on the list of hospital challenges for revenue integrity, billing and appeal/denial teams. Adding to the challenges, a disconnect often exists outside of the laboratory when it comes to the medical indications and testing methodology that guide selection of CPT/HCPCS codes and modifiers.
Let us help bridge that gap.
With discussion of everyday scenarios and logic behind code selection, leading expert Robin Zweifel will walk you through some of the core topics that are sure to benefit laboratory and revenue integrity staff alike. Robin aims to build a foundation with an overview of industry documentation, coding and billing guidelines to lead into the primary focus of this session – common coding errors that result in claim edits or denials and appropriate corrective actions. In addition, Robin will break down NCCI rules and appropriate modifier selection. Robin's objective: to have you walk away equipped with a strengthened understanding of laboratory coding and billing with actionable strategies, tips and tools that improve your daily operations while cultivating solutions for coding confidence.
What's on the agenda:
- A review of CPT/HCPCS coding, documentation and billing guidelines for laboratories
- How to prevent or correct common coding errors that result in claim edits or denials
- The dos and don'ts of modifier usage for laboratory services, in compliance with NCCI rules, including the use of modifiers to resolve procedure-to-procedure (PTP) edits or medically unlikely edits (MUEs)
- Adhering to payer policies and coverage limitations to ensure the appropriate reimbursement
- Everyday examples to reinforce the logic behind proper code selection, charge capture and claims submissions
- A look ahead to anticipated CPT code changes for 2020
- Time permitting, answers to attendee questions
CPT® is a registered trademark of the American Medical Association.