Medical Billing for Pathology and Laboratory Services

Medical Billing for Pathology and Laboratory Services

Medical billing is the process by which healthcare agencies submit and follow up on claims to insurance companies for healthcare and medical-related services. It is a contract between insurance agencies and medical practitioners.

Medical offices including pathologists and laboratories often look to a medical billing agency such as MPMR to ensure the billing is coded properly for the insurance agencies. Normally, medical Medical billing for laboratoriesbilling follows a pattern set forth in the ICD-10-PCS, which carefully and specifically codes medical procedures.

MPMR has extensive experience with pathology practices and laboratories, helping maximize reimbursement.

Correct Coding Structure

  1. The first character of the code is representative of the category under which the procedure falls. For example, the number 0 represents the Medical and Surgical category, 1 represents Obstetrics, and B represents Imaging.
  2. The second character represents the body system the procedure or diagnosis affects. The Central Nervous System is coded 00 and the Peripheral Nervous System is coded 01. Each character builds upon the one that came previously.
  3. The third character is determined by the root operation.
  4. The fourth is established by the body part being affected.
  5. The fifth character is decided by the approach to the procedure, which is open or percutaneous.
  6. The sixth character is determined by the device used to perform the procedure.
  7. The seventh character is used as a qualifier in order to provide the biller with any other pertinent information about the procedure.

Billing for Laboratory Procedures

Laboratory medical billing companyThe billing codes for laboratory procedures fall in the category beginning with the number “8” which denotes Other Procedures. From there, the code will designate what type of procedure is being performed. For example, if a physician has requested a blood test, the billing code will be 8C02X6K. The “8” represents the category, Other Procedures. The “C” signifies an indwelling device will be used in the procedure.

An indwelling device is a tube that is inserted into the body in order to drain fluid, in this case, blood. The “0” indicates that the procedure is an “other procedure” once again. The “2” codes the procedure as a procedure involving the circulatory system, which is the system concerned with blood. The “X” marks the procedure as an external procedure as opposed to an internal one. The “6” and the “K” reiterate that it is blood that is being taken from the patient through an indwelling device.

Other Procedures in Laboratory Billing

There are laboratory tests other than fluid tests that fall under the billing category of “Other Procedures” as well. These labs are placed in a billing code beginning with 8E representing Physiological Systems and Anatomical Regions. An example of an instance of when this type of billing code is used is if a physician orders an exam of the female reproductive system, where the code for this is 8E0UXY7.

The “8E” represents other procedures in the physical systems and anatomical regions. The “0” signifies another subset of other procedures and the “U” exemplifies the exam is of the female reproductive system. The “X” shows that the procedure is an external one. The last two characters restate the procedure as an examination of the female reproductive system.


The coding allows the correct medical procedure to be billed to the patient’s insurance Medical Billing Neurologycompany. The specific code makes it easier for the billing systems to convert the code to the proper billing information. The codes in the ICD-10 are specific enough to give a very exact code to any lab test that is ordered to ensure the proper billing procedures are followed.

MPMR is a top medical billing company for laboratories, pathology and all kinds of medical practices. Call today for a free consultation to see how MPMR can help your practice or laboratory streamline its billing!



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