Attend Pathology Coding Conferences And Protect Your Lab's Payments

By Author: Julia Rose
Total Articles: 89
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Normally, the second quarter is a quiet one for CCI edits, but it's not the case this year. There are many new edit pairs that you'll have to maneuver in the latest CCI update if you want to protect your lab's pay. Version 15.1, which went into effect from April 1, has 304,038 additions.


With new limits on code combinations from pathology coding consultations to molecular diagnostics and micro dissections, you need to tackle nearly 40 changes in laboratory/pathology alone.


CCI already bundles hundreds of lab codes with pathology consultation 80500 and 80502. The April 1 CCI update continues the tradition by adding edit pairs between 80500/80502 and the following three procedures:


86356 - Mononuclear cell antigen, quantitative, not otherwise specified, each antigen

87500 - Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (e.g., enterococcus species van A, van B), amplified probe

87809 - Infectious agent antigen detection by immunoassay ...
... with direct optical observation; adenovirus.


These edits show that you cannot bill Medicare for a pathologist's medical direction and supervision of clinical lab tests under the guise of an 80500 or 80502.


But that doesn't mean a pathologist cannot charge for an 80500 or 80502 consultation related to lab tests such as these immunology and microbiology procedures. If the physician requests a consultation on an abnormal lab test result and the pathologist renders a professional opinion and files a report, you can go for 80500 or 80502 with any of the bundled lab codes by appending modifier 59 to the consultation code.


To keep pace with such CCI edits, try attending pathology coding conferences and see how they make a difference to your pathology coding career.


Gain knowledge about medical coding by attending proper medical coding conferences along with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.