Coding Essentials for Laboratories

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Coding Essentials for Laboratories

Product Code: DHZMEDPCEL20

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Coding Essentials for Laboratories

Much more than a laboratory coding guide…a complete solution to tackle the challenges wrecking your revenues

Today 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 the 2020 edition of Coding Essentials for Laboratories.

Did you know that some of the 100-plus new PLA codes for 2020 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 lab panels? Likewise, Recovery Audit Contractors (RACs) are targeting some laboratory tests for proof of medical necessity.

In the 2020 Coding Essentials for Laboratories, our experts will help you steer clear of these and many other potential pitfalls, while dissecting and explaining the 2020 code changes pertaining to chemistry testing, microbiology and molecular pathology. As always, you can count on this time-trusted resource to guide you quickly to the correct codes for laboratory and pathology services.

Don’t let outdated or incomplete information sabotage your compliance. Join the numerous professionals across the country that have embraced our resource for a full range of laboratory solutions.


Published: December 2019

ISBN: 978-1-63151-227-8

Features and Benefits 

  • Updated and expanded content for 2020, including:

    • Explanations and practical application of 2020 coding changes, including new codes for chemistry testing, microbiology and molecular pathology
    • Expanded guidance for Proprietary Laboratory Analyses (PLA) codes; covers the expansion of PLA codes to certain microbiology tests and other services that also have a Category I CPT code — a scenario with a high risk for confusion, miscoding and claim denials
    • New guidance with coding instruction contained in the 2019 NCCI narrative, which changed the way lab panels may be billed (an area targeted for payer audits)
    • Further instruction on drug-of-abuse testing, including clarification of what a presumptive test actually is, how to bill when drug monitoring coincides with drug-of-abuse testing and code unbundling when testing for certain substances
    • New clarity on how to correctly establish medical necessity for vitamin D assay testing (CPT codes 82306 and 82652) — now an approved RAC target
    • Updated payment information, including the 2020 CLFS and its impacts
    • A breakdown of the proper use for modifier 59 
  • Our experts address common questions, concerns and problem areas:
    • Coding for diagnostic vs. preventive Pap smears
    • Billing under a device code or as a lab-developed test
    • Coverage limitations for clinical drug testing
    • Coding for molecular pathology
  • 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
      • Chemistry
      • Microbiology
      • Preventive services
      • Hematology
      • Blood banking
      • Transfusion medicine
      • Cytogenetics
      • Histology
      • 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

CPT® is a registered trademark of the American Medical Association.