Laboratory Billing Expert | XyberMed

EFFICIENT LABORATORY MEDICAL BILLING SERVICES FOR COMPLETE OPTIMIZATION

The field of medical laboratory billing is under intense scrutiny. Following the OIG's announcement of a close review of independent labs' billing practices, CMS has increased its oversight of labs, making the billing process much more complex. As reimbursement rates get lower, costs get higher, and billing standards get more stringent, the need for competent and compliant laboratory-based billing services is at its highest.

Familiarity with laboratory medical billing HCPCS, CLIA changes, PAMA updates, is what is important for medical billers. Familiarity with comprehensive laboratory services such as biological, serology, hematology, and cytology testing is critical. The likelihood of errors should be minimal. At Bikham, we understand the many challenges laboratories face when it comes to billing. The complexity of laboratory billing standards, ever-changing payer requirements, and difficulty accessing information can hinder growth and affect the success of your business. With more than 14 years of experience in laboratory billing, we can overcome these volatile billing challenges with ease, allowing our clients to focus on their core competencies and consequently increase their bottom line.

MOLECULAR BILLING AND CODING Molecular laboratories are in high demand. Increasing demand brings growth. But with that comes great responsibility and challenges in billing and coding. The molecular testing industry has been dynamic, and CMS reviews the most commonly tested genes each year to rewrite codes, making it difficult to keep up.

Non-compliance makes billing difficult. To ensure proper reimbursement for molecular laboratory testing, it is imperative that laboratories stay abreast of billing and coding updates and practices.

Bikham has the expertise to provide expert molecular billing and coding services. We ensure maximum reimbursement, full compliance with old and new laboratory test billing guidelines, and also take care of follow-up procedures so you don't have to.

BILLING SERVICES FOR TOXICOLOGY LABORATORIES Toxicology laboratory billing is the most unpredictable and frequently changing area of laboratory billing. Medicare's introduction of G-codes in 2016 to classify testing procedures was a game changer. Three categories of G-codes, each for presumptive and definitive tests, were created to address overutilization and other incorrect practices.

Overutilization is another focus of careful scrutiny by CMS, the OIG, and the U.S. Department of Justice. Therefore, in order to receive appropriate reimbursement, laboratory billing professionals must stay current.

Knowing the rules for applying modifiers and diagnosis codes is important. Bikham's team has helped toxicology laboratories increase revenue with its highly competent billing services.

BILLING FOR PATHOLOGY LABORATORY SERVICES Billing for pathology laboratory services can be particularly challenging. It is necessary for billing representatives to understand the many subspecialties of pathology such as cytopathology, toxicology, hematology, etc.

Complicating matters further, pathology laboratory billing is governed by a multitude of rules and regulations. Therefore, it is imperative that pathology laboratory billing professionals are familiar with the same in order to achieve lucrative results. A thorough understanding of pathology lab terms and procedures ensures a smooth billing transition and overrides billing challenges, resulting in fewer denials and higher payments.

At Bikham, we constantly strive to keep up with changes in CPT codes, CCI edits and pathology lab billing guidelines, leaving virtually no room for error.

BILLING SERVICES OF A CLINICAL LABORATORY Services provided by a clinical laboratory include pathological, biological, chemical, microbiological, biophysical, hematological and immunohematological, serological, cytological, and other procedures. To qualify, these services must meet the requirements identified in 42CFR Part-493 of CLIA, 1988. In addition, CPT4-80000

series and ICD-10 diagnosis codes are required for billing clinical laboratory tests.

There are exceptions to the use of diagnosis codes that must be considered.

The margin for error is small, and no practice can afford to lose money and invest precious time fighting and disputing denials. Our team of billers and coders understand the requirements to ensure medical necessity and are familiar with the latest technology and ever-changing CPT and ICD-10 codes.