New ICD 10 Codes for Pathology Billing – Is your Practice Ready?

Your practice has until October 1, 2022, to begin reporting the new 2023 ICD-10-CM codes — and with over 1,000 new diagnosis codes added to your available options, you’ll want to make the most of that time. CPT codes, as you are aware, answer the question “what happened?” when you see a patient. On the contrary, ICD-10-CM codes denote the “why?” which is the most important way you can prove medical necessity for the services your practice provides. Furthermore, if you do not demonstrate medical necessity, you will be denied reimbursement and lose money. Let’s know about New ICD 10 Codes for Pathology Billing.

Updates to the 2023 Physician Fee Schedule

On July 7, the Centers for Medicare and Medicaid Services (CMS) released its proposed 2023 Medicare Physician Fee Schedule. For 2023, there are 331 new codes and 64 deleted codes, for a total of 78,496 ICD-10-PCS codes. Medical billing and coding services providers must become acquainted with these changes, which will affect reimbursement for inpatient facilities such as skilled nursing facilities, acute and long-term care hospitals, and home health care services.

The goal of these changes is to ensure that payments for the technical component of pathology are more accurate next year. They will also reduce pathology payments by about 1% between 2022 and 2023. To account for the expiration of the 3% fee increase for 2022, the conversion factor will be reduced by 4.4%.

New Category 3 (temporary) Codes in Digital Pathology (Effective 2023)

Beginning January 1, 2023, the College of American Pathologists (CAP) has announced thirteen (13) new digital pathology Category III CPT codes. Clinical staff work associated with digitizing glass slides for the primary diagnosis will be defined by codes 0751T through 0763T as per CAP.

The goal of digitizing glass microscope slides is to enable remote examination by pathologists and/or the use of artificial intelligence (AI) algorithms. When the digitization procedure of glass microscope slides is performed and reported in conjunction with the Category I code for the primary service, Category III add-on codes 0751T-0763T may be reported along with the appropriate Category I service code.

Do not report Category III codes in this subsection for archival purposes (e.g., after the Category I service has already been performed and reported), educational purposes (e.g., when services are not used for individual patient reporting), developing a database for training or validation of AI algorithms, or clinical conference presentations (e.g., tumor board interdisciplinary conferences).

The preliminary codes published by the AMA are as follows:

  1. Digitization of glass microscope slides, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure)
New ICD-10 CodesFor LevelCan be used in Conjunction with
+0751TLevel II88302
+0752TLevel III88304
+0753TLevel IV88305
+0754TLevel V88307
+0755TLevel VI88309
  • Digitization of glass microscope slides for special stain, including interpretation and report (List separately in addition to code for primary procedure)
New ICD-10 CodesFor GroupUsed forCan be used in Conjunction with
+0756TGroup IMicroorganisms (e.g., methenamine silver, acid fast)88312
+0757TGroup IIAll other (e.g., trichrome, iron), except stain for microorganisms, enzyme constituents or immunohistochemistry and immunocytochemistry88313
+0758THistochemical stain on frozen tissue block88314
+0759TGroup IIIEnzyme constituents88319
  • Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen (List separately in addition to code for primary procedure)
New ICD-10 CodesStain ProcedureCan be used in Conjunction with
+0760TInitial single antibody stain procedure88342
+0761TEach additional single antibody stain procedure88341
+0762TEach multiplex antibody stain procedure88344
  • Digitization of glass microscope slides for morphometric analysis, tumor immunocytochemistry, quantitative or semiquantitative, per specimen (List separately in addition to code for primary procedure)
New ICD-10 CodesStain ProcedureExample Can be used in Conjunction with
+0763TEach single antibody stain procedure, manualHer-2/neu, estrogen receptor/progesterone receptor88360

Changes in Pathology Coding

The 2023 ICD-10-CM codes will be implemented on October 1, 2022, with over 1,400 new diagnostic codes added. All payers, including Medicare, Medicaid, and TRICARE, must receive new codes. Because these codes indicate the necessity of medical services, improper use of the codes may result in denied claims and loss of reimbursement for services rendered.

The following are some of the new codes’ highlights:

  • Code expansion for OB/GYN (includes more than 400 new codes)
  • Code expansion for concussion/brain injury (includes more than 100 new codes)
  • Dementia cod expansion (includes nearly 100 new codes)
  • Code expansion for methamphetamine overdose (new code category for poisoning by meth)
  • Codes for electric bike injuries (allow for additional information about the accident)

How to Prepare for New ICD 10 Codes for Pathology Billing?

Proper reimbursement for pathology healthcare services is only possible if the services are correctly coded in claims submitted to insurance companies. To handle your new ICD coding needs for pathology billing, the best solution is to outsource pathology billing services to 24/7 Medical Billing Services. With relevant industry experience, we manage every aspect of the coding process and assist you in better managing your revenue cycle.

As a leading medical coding outsourcing company, we are better equipped to provide our clients with ICD-10-compliant coding services. With more specific codes available in the ICD-10 coding system, our coders select the ICD 10 Codes for Pathology Billing that most accurately reflect the patient’s care. We follow AMA and CMS guidelines and assign the most up-to-date medical codes for the services you provide to your patients.

Read more: Pathology Billing Services-All You Want To Know?

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