Billing for clinical, molecular, and pathology labs with payer-specific compliance and panel bundling expertise.
Laboratory billing requires expertise in proper bundling of panel components, reflex testing, and add-on tests to comply with payer edit rules.
Payers require specific ICD-10 codes and proper linking to support medical necessity for laboratory tests, especially high-cost molecular testing.
Each payer has unique Local Coverage Determinations (LCDs) and coverage policies that vary by test type and frequency.
Laboratory billing requires precise modifier usage including 91, 59, and QW to indicate test circumstances and prevent unbundling errors.
Advanced Beneficiary Notices must be properly obtained, documented, and billed with correct modifiers when tests may not be covered.
Clinical laboratories process thousands of claims daily requiring automated systems and quality controls to maintain accuracy.
Certified coders with specialized training in clinical, molecular, and pathology laboratory billing requirements.
Advanced billing software with built-in laboratory-specific edit checks and payer rule validation before claim submission.
Comprehensive review processes ensure proper diagnosis code linking and medical necessity documentation for all tests.
Strategic approach to maximize compliant reimbursement and minimize denials through proactive management.
Complete billing for routine and specialty laboratory testing including chemistry, hematology, immunology, and microbiology.
Specialized billing for high-complexity molecular diagnostics, genomic testing, and genetic counseling services.
Professional and technical component billing for surgical pathology, cytology, and immunohistochemistry.
Comprehensive LCD monitoring and compliance management for all covered laboratory services.
Medtransic's laboratory billing team understands the complexity of molecular testing and LCD requirements better than anyone. They reduced our denial rate from 28% to under 8% and improved our cash collections by 40%. Their expertise in panel bundling and medical necessity has been invaluable.
Contact Medtransic today for expert laboratory billing services. Call 888-777-0860 or visit https://medtransic.com/contact for a free consultation.