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5 Rules Pinpoint Date of Service for Laboratory Claims

Tip 3: Here’s DOS advice for archived samples.
You can’t afford to get the date of service (DOS) wrong on claims that undergo CMS edits — mistakes could mean you’ll face fraud charges. That’s because Correct Coding Initiative (CCI) edits and Medically Unlikely Edits (MUEs) control payment for procedures on the same DOS.
But for pathologists, choosing the date […]

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Got Multiple Modifiers? How To Sequence Them on the Claim

Coders like to say that modifiers help them tell the story of what happened in the operating room, hospital, or doctor’s office. But what if the story you have to tell is very long and complicated?
Bookmark these 4 modifier ordering tips from Becki Geraud, CPC, CEMC, RCC, who presented at the Otolaryngology Specialty Coding Conference […]

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Which HCPCS Code Should I Use for Eovist MRI contrast?

Question: Which HCPCS code should I use to report Eovist MRI contrast?
Answer: You should verify the appropriate code with your payer, but the most likely option is A9579 (Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified [NOS], per ml).
Here’s why: HCPCS doesn’t currently offer a specific Eovist (gadoxetate disodium) code for physician claims. (Code […]

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