Pathology Medicine Billing Services
Pathology billing is unlike any other medical specialty; it demands a granular understanding of diagnostic coding, precise documentation, and payer-specific nuances. From surgical pathology to molecular diagnostics, billing in this field requires specialized knowledge and accurate code capture across various disciplines.
Our tailored billing solutions help pathology providers, independent labs, and hospital departments minimize denials, reduce manual errors, and accelerate the payment cycle. Whether it’s CPT, HCPCS, ICD-10, or modifier use, we ensure everything is accurate, complete, and audit-ready.
Why Pathology Billing is Intricate
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Dual components: technical + professional billing
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Frequent use of modifiers (TC, 26, 91, 59)
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Multiple testing types: qualitative & quantitative
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Complex panels, reflex tests, and genetic studies
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High volume of claims with low per-claim value
Core Pathology Billing Services We Offer
Our pathology medical services cover everything from start to finish, fully integrated with your lab systems.
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Eligibility Verification & Prior Authorization
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Accurate Charge Entry for all subspecialties (Cytology, Hematology, Molecular, Anatomical, Clinical Pathology)
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CPT, HCPCS & ICD-10 Coding – Using specialty-specific rules
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Claim Scrubbing before submission to catch errors
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Electronic Claims Submission – 48-hour turnaround
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Payment Posting & Denial Management
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A/R Follow-up & Recovery
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Audit & Compliance Monitoring (CLIA, HIPAA, Medicare Part B)
Pathology Specialties We Handle
We bill across all major branches of pathology, including:
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Disease-oriented panels
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Molecular pathology
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Urinalysis & in-vivo lab procedures
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Surgical pathology
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Hematology
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Cytopathology
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Reproductive medicine
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Anatomical & clinical pathology
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Toxicology & drug assay panels
Proven Outcomes
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98.6% billing accuracy
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<4% denial rate
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Claim turnaround: under 48 hours
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70% improvement in revenue cycle efficiency
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25–30% increase in cash flow & collections
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A/R days cut down to <30
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Up to 11.5% increase in reimbursements year-over-year
Coding Examples
We follow payer-specific guidelines and assign correct CPT/HCPCS codes, including:
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88302 – Surgical pathology, gross and microscopic examination (Level II)
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88304 – Surgical pathology, gross and microscopic examination (Level III)
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88305 – Surgical pathology, gross and microscopic examination (Level IV)
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88309 – Surgical pathology, gross and microscopic examination (Level VI)
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88342 – Immunohistochemistry, each antibody
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88142 – Cytopathology (Pap smear, manual screening)
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Common ICD-10 codes for pathology: C50 (breast cancer), D05 (carcinoma in situ), C21 (rectal cancer), C18 (colon cancer), D12 (benign neoplasms)
Who We Serve
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Independent pathology labs
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Hospital-based pathology departments
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Genetic & molecular diagnostic centers
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Toxicology labs
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Dermatopathologists, hematopathologists, and surgical pathologists
Why Choose Us for Pathology Medical Services in New York?
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Certified Pathology Coders with CPC, CPB, and CPMA
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Deep expertise in reflex/add-on testing billing
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Seamless integration with LIS (Lab Information Systems)
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Dedicated team for specialty-specific audit prep
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Transparent reporting dashboards with real-time updates
Book a Free Pathology Medicine Billing Audit Today!
Frequently Asked Questions (FAQs)
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We apply TC and 26 modifiers to distinguish technical and professional services and ensure payer-specific reimbursement.
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Yes, our team is experienced in reflex and add-on test billing, especially for molecular and immunological panels.
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Absolutely. We assist in audit readiness, CLIA compliance checks, and payer audit responses with complete documentation.
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We scrub and submit clean claims within 24–48 hours of receiving complete documentation.
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We support seamless integration with popular LIS platforms and EMRs to reduce manual work and sync lab results with coding.
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Yes, whether you're hospital-affiliated or independent, our services adapt to your lab workflow and scale.
