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In this convenient "one-stop webcast," our laboratory coding expert Robin Zweifel brings you up to speed on new, deleted and revised codes for laboratory and pathology services, plus CLFS and OPPS payment changes and the latest on PAMA. She also brings clarity to some of the most challenging areas for clinical laboratories, including date-of-service rules, drug-of-abuse testing and documentation issues.
IN-DEPTH DISCUSSION OF 2019 CHANGES:
- Many new, deleted and revised CPT®/HCPCS codes for reporting laboratory services, including:
- Molecular pathology
- Genetic sequencing
- Small dense LDL cholesterol quantitative test
- Dihydrotestosterone (DHT) chemistry test
- Numerous updates to Proprietary Laboratory Analyses (PLA) codes
- Clinical Laboratory Fee Schedule (CLFS) and Outpatient Prospective Payment System (OPPS) payment changes
A special focus on areas of concern, confusion and noncompliance:
- Extensive discussion of the Protecting Access to Medicare Act (PAMA), including the new definition of "applicable laboratory" and impact of recent developments on CLFS payments
- Explanation of date-of-service (DOS) rules applicable to diagnostic lab tests, plus recent policy changes and how to satisfy Medicare requirements
- CPT coding guidelines for drug-of-abuse testing, chemistry, hematology, urinalysis, immunology, microbiology and molecular pathology
- The unique challenges and compliance concerns associated with drug-of-abuse testing
- Strategies for protecting the revenue integrity in the face of many threats
- Recovery audit contractor (RAC) targets, including the use of add-on codes when a primary code is missing or denied
- Guidance with detecting and fixing documentation weaknesses that can lead to payment denials; includes the critical difference between "medical necessity" and "medically indicated"
- AND MORE!
CPT® is a registered trademark of the American Medical Association.
About the Presenter
Robin Miller Zweifel, BS, MT (ASCP)
A proven leader in revenue cycle management, Robin is Interim Director, Revenue Integrity at Harmony Healthcare. She possesses more than 20 years of experience as a medical technologist, coupled with 18-plus years as a healthcare consultant with special expertise in revenue integrity and compliance. As a consultant, Robin worked with clients to improve charge capture workflow, enhance CPT® coding integrity, resolve billing errors and implement documentation improvement programs. She has also developed, managed and implemented CDM projects for multi-facility organizations. Robin previously worked for Panacea Healthcare Solutions as a consultant and auditor.
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