Practical Guide To Pathology Billing & Coding Services 2023

Pathology medical billing services are a set of services that help medical providers to manage their billing process. These services include electronic systems and software responsible for collecting patient information from insurance companies. Moreover, the most important thing you need to know about pathology billing is that it is essential for your business’s success. Because it helps you collect money faster than other methods, such as paper or manual billing, can do so.  

In addition, the pathology field is constantly evolving to make things clear and straightforward for insurance and medical billing specialists. But regrettably, these intricate and constantly altering codes make it challenging for many healthcare service providers to bill independently or through an internal billing team. The smart move in this circumstance is to hire pathology billing professionals to handle the work for you. 

The medical billing for pathology is more complex than other specialties due to the complexity of the DX and CPT codes. Selecting the correct billing services provider is necessary to increase your revenue cycle and handle your specialized medical billing properly. So, read the blog to know what you should consider before hiring a good services company. 

What are Pathology billing services?

These specialized medical billing services work with pathologists and other doctors who perform tests to diagnose and treat diseases. Moreover, these services specialize in collecting insurance payments for pathology tests. Qualitative and quantitative testing are both used in pathology. Quantitative tests measure the amount of a chemical in the body, while qualitative tests detect its existence. How much calcium, for instance, does your body contain?

For hospital-based services, pathology billing has its standards that might get problematic. Regulations, payer obligations, hospital compliance, and other measures are occasionally outdated.

Which tests are included in pathology billing?

The tests that are included in pathology billing include:

Drug testing

It initially establishes the presence of a drug (qualitative) before showing its concentration (quantitative). Each type of medication has a unique code that must be carefully entered during billing. 

There are varied pathological tests –

Pathology is the area of medicine that investigates disease processes and the effects of drugs, chemicals, and other physical agents on tissues. Pathologists diagnose diseases by examining body tissues and fluids under a microscope. So, below are several different tests that come under it: 

• Microbiological tests determine the presence of microorganisms like hepatitis, giardia, HIV, or rubeola. Specific codes are given to each of them.
• The diagnosis is tested and confirmed using molecular pathology procedures that examine antigens, genes, and a few biological processes.
• The examination of human tissue is a part of surgical pathology. The levels that make up the surgical pathology codes cover a broad range of topics. The code groups are arranged according to the complexity and cost of the procedure. A higher level of code will be used for the more expensive or challenging method. So, when you hire a pathology billing company, they will do all the above tests.

Important Codes

You should know the codes you will use when filing your claim. The codes categorize and identify tests, procedures, and other medical procedures. In addition, they help payers understand what was done during a visit or process so they can determine if they will cover it.

Many different types of codes can be used in medical billing claims:

• CPT (Current Procedural Terminology) is healthcare providers’ most widely accepted coding system worldwide. It contains detailed descriptions of each procedure and any associated equipment costs and facility fees that may be involved with performing said procedure/treatment on a patient at an institution like yours!

• HCPCS (Healthcare Common Procedure Coding System) – Another widely-used coding system that provides more specific information about individual services performed by healthcare professionals such as nurses or physicians who work within hospitals/clinics across America today!

Below are the pathology codes that billing companies use: 

Field Code Range

Anatomic Pathology 88000 – 88099

Hematology and Coagulation 85002 – 85999

Clinical Pathology Consultation 80500 – 80502

Surgical Pathology 88300 – 88399

Urinalysis 81000 – 81099

Molecular Pathology 81200 – 81479

Drug Testing 80100 – 80104

Chemistry 82000 – 84999

Cytopathology 88104 – 88199

Microbiology 87001 – 87999

Here are the top ICD-10 codes for pathology coding –

ICD-10-CM Code K29.50 – Medical ailments related to gastritis

ICD-10-CM Code K20.8 – Medical diagnosis of the allergic inflammatory condition in the esophagus

ICD-10-CM Code N20.1 – Code for kidney stones

ICD-10-CM Code C50.911 – Code that helps specify Breast cancer in women

What can Medical billing services do for your pathology practice?

Pathology medical billing services are essential for pathology practice. These billing services can help you save time and money, improve your business and increase revenue.

Moreover, these services are a great way of increasing the number of patients who visit your office. They also allow you to collect more money by offering them services such as insurance claim forms, claim status updates, patient reviews, lab results, etc.

You must understand all the different types of medical billing services available to make sure that they fit into your budget as well as meet all of your needs when it comes time for payment later on down the road when bills come due every month or quarter, depending on which plan. So, here are the benefits that you would get from hiring these services. 

Billing medical billing companies can be a perfect way to assist you in growing your practice. The benefits of medical billing include the following:

You have increased revenue and profitability. Medical billing allows you to charge for your services, so you can increase your revenue and get the most out of each patient visit or procedure.

Reduced costs. Using a billing company can decrease the amount of time spent on paperwork and other administrative tasks. So this would free up more time for patient care and results in lower costs overall.

Better customer service experience. When patients need to communicate with their doctors, they are more likely to have a positive experience, so if you use a reliable billing company instead of doing it themselves since there’s clarity about who is responsible for paying what bill.

 Increased patient satisfaction rates. Patient satisfaction rates tend to go up when people know exactly how much it will cost them for their visit or procedure, so having this information available from your medical billing company helps ensure that everyone is on board with the plan from start to finish.

Services for Pathology Benefits Verification

Even though it’s important to verify each patient’s eligibility before submitting a claim, we always verify each patient’s eligibility and benefits when billing for pathology specialty claims. In order for us to act appropriately and promptly, our eligibility confirmation services team examines whether or not this patient plan covers treatments linked to pathology. We determine the patient obligations (including the copay, coinsurance, and deductible) following the benefits verification, and we update permission (if required).

How Can CureCloudMD Assist In Billing Services?

CureCloudMD is a medical billing company that provides billing services for pathologists. We have a team of experts who are well-versed in billing services, and they can help you with your billing services.

We provide a variety of services that cover everything from telephonic billing to e-billing, invoicing, and more. Their team of experts knows how difficult it can be when there are issues with your billing process, so they can help you resolve any problems that may arise.

They offer a variety of programs that can help physicians manage their accounts better than ever before. For example, they provide an online portal where physicians can upload their information into an electronic system and use it whenever needed. This helps them stay organized and makes it easier to keep track of everything related to their practice.

Medical billing services Practice Management Services

Increase Productivity

Assisting you in finishing your activities quickly will enhance your workflow and increases your job efficiency. The committed team uses cutting-edge technology and current methods to help you complete your duties faster and with fewer resources.

Boost Earnings

Using numerous methods, such as appointment scheduling, error elimination through automatic insurance eligibility checks, error notifications, and much more, direct and aid you in increasing your profits and revenue. Because of this, the team makes sure to reduce denials and boost your revenues.

Assistance in making the right choice

They specialize in making sensible financial and operational decisions while keeping you informed of the most recent changes that need to be made as soon as possible. Incorporating integrated dashboards guarantees quick performance, enabling reports to offer insightful analysis. Additionally, it is simple to integrate data into your decision-making thanks to the flexibility to examine standard reports or personally personalize them.

Managing Pathology Denials

For any healthcare service provider, claim denials can result in a significant loss. However, you can get excellent denial management from our pathology denials management staff. With their years of pathology billing knowledge, they are fully aware of MACRA and know what to do in the event of any potential denials that may arise while charging for pathology practices.

Patient Information and Billing Services

The demographics entry is crucial before creating a claim for any patient. To prevent denial or rejection, we ensure to include patient information by the patient data in the insurance system. In addition, our charge entry services team makes sure to enter the proper charges from superbill because the insurance bill relies on the amounts we bill. So, if you hand us the work you would not regret it. As our professionals always make sure to serve the clients in the best way. 

Assistance in making the right choice

Our company makes sensible financial and operational decisions while keeping you informed of the most recent changes that need to be made as soon as possible. Incorporating integrated dashboards guarantees quick performance, enabling reports to offer insightful analysis. Additionally, it is simple to integrate data into your decision-making thanks to the flexibility to examine standard reports or personally personalize them.

Guidelines for improved Pathology billing

• Recognize which pathology services are billable under split billing and which are not.
• By identifying and correcting billing code problems, pathology claims scrubbing lowers the number of refused or rejected claims.
• Since patient demographics contain all of the client’s information and medical history, accuracy in filling them out is crucial.
• To prevent delays, keep track of the claims that are generated and the collections that are handled. Take note of and follow up on the Aged Claims as well.
• Using codes and modifiers properly is a crucial duty. Applying standard CPT, HCPCS procedure and supply codes, and ICD-CM diagnosis coding by CMS guidelines is vital.

Conclusion:

Now that you know what CureCloudMD Billing services are and how they can help you with your pathology practice, it’s time to start! We provide the best pathology medical billing services. Our billing and coding specialists are just a phone call away, and we’re here to help you any time of day. So, get in touch with us immediately to acquire answers to your questions about medical billing.