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Tips and Tools for Improving Laboratory Revenues

December 7, 2010
Presented by the Louisiana Hospital Association
LHA Conference Center
2334 Weymouth Drive, Baton Rouge, LA 70809
(225) 928-0026

Faculty Betty Hatten, CPC-H, MHS, MT(ASCP), is a manager in the Revenue Cycle practice of HORNE's health care consulting services.

Objectives

• Review CPT and HCPCS codes used in clinical and pathology labs
• Identify common outpatient coding errors that can result in revenue loss
• Provide tips and tools for the non-lab coders, billers and auditors
• De-mystify laboratory and blood bank modifiers
• Navigate the World Wide Web and the www.cms.gov Web site with particular emphasis on transfusion medicine

Description
Laboratory charge capture can be as simple as looking up "cholesterol" in the CPT book. It can also be at the opposite end of the spectrum in complexity when it comes to coding a positive culture, a molecular genetics panel or an esoteric test sent to a reference lab. Because lab reimbursement is so low, it is often below the threshold of patient financial services (PFS) and is "written off" or removed from claims when there is an edit. But also because the volume of lab tests is so high, this practice at even a small hospital can result in tens of thousands of dollars. This face-to-face day long course will drill down to the specifics, the differences and the modifiers for complete and accurate charge capture for all areas of the lab.

We'll look at laboratory CPT/HCPCS Code selection for the Chargemaster development and use, discuss coverage policies, review the laboratory Correct Coding Edits and Medically Unlikely Edits. We will explore the most common lab denials, how much revenue we are losing and how to prevent it. Participants will walk away with flowcharts for the microbiologist and blood bankers, know how to navigate the "web" to find the information and we'll teach the non-laboratory coders, billers and nurse auditors how to speak "lab." Plus an added bonus, we'll talk about how to get the physicians to give us the signs and symptoms we need for proper reimbursement.

Who Should Attend
Laboratory managers, supervisors and educators; lab software vendors or lab IT staff; pathologists, cytologist and histotechs, coding professionals, denial management staff and internal nurse auditors; business office staff, physician office managers and physician office lab staff; and students enrolled in clinical laboratory science program

Continuing Education Credit
Participants will receive, upon completion of workshop, a certificate documenting the completed continuing education/clock hours.