Two Decades of Supporting Laboratory Coding and Billing Best Practices

People sometimes ask, “What sets MedLearn Publishing resources apart from other products on the market?” First and foremost, we rely on experts — individuals who live, breathe and immerse themselves in the subject matter of a particular product line — for the content of all our resources.

Nobody exemplifies this better than Robin Miller Zweifel, BS, MT (ASCP). In 2000, Robin joined MedLearn as a Senior Healthcare Consultant, bringing with her many years of experience as a medical technologist for a clinical laboratory and later as an independent consultant. She was instrumental in the development of Coding Essentials for Laboratories, first published in 2003, as well as other MedLearn Publishing resources, including our annual Laboratory Coding Update webcast and monthly Laboratory Compliance Manager newsletter.

Today, as Director of Coding and Billing Compliance for a laboratory testing solutions company, Robin continues to be a key contributor to MedLearn Publishing laboratory resources. For this “Industry Expert Review,” we wanted to find out why she believes our laboratory products have been so popular for the past two decades.

Highlights of Robin Miller Zweifel’s comments…

Driving the need: Twenty years ago, laboratories didn’t have a resource that consolidated laboratory coding, billing, and compliance information from various sources into a single point of reference. Secondly, lab professionals, while well-educated in laboratory science, typically lack knowledge about the business side of their operations, specifically coding and billing. Moreover, they tend to find it difficult to take time away to research coding and billing issues because they’re so focused on core laboratory responsibilities.

Meeting the need: MedLearn Publishing’s laboratory resources integrate payer and regulatory information from CMS, AMA, and other entities; this saves customers from the time-consuming and potentially confusing task of trying to connect the dots across multiple resources. In addition, we explain coding and billing in lay terms, clearly mapping these concepts back to lab methodologies and technologies. In other words, we simplify coding and billing for busy laboratory managers and staff. At the same time, these resources are ideal for coders, billing staff, and others who may not understand laboratory science.

Favorite features of Coding Essentials book: I really like the tables — they provide a lot of valuable information at a single glance. For example, the book has tables that crosswalk users from CPT^® codes to revenue codes, making it easier to build a chargemaster. Another valuable feature of the book is the coding flowcharts, or decision trees, that enable users to quickly land on the correct CPT code.

Our other laboratory resources: They do a great job of complementing the book. For example, the newsletter discusses and offers guidance on new regulations and other emerging issues. The annual update webcast, besides previewing the coming year, uses a live, interactive format to address the challenges that customers are experiencing.

For training new staff: Recent staffing shortages and turnover have hit clinical laboratories especially hard. As a result, laboratories are staffed by a lot of individuals who are fresh out of school, as well as by retirees who are returning to work. They all need on-the-job training, and the book in particular is a great educational resource because it uses everyday language, along with quick-reference tools, to link laboratory services with correct coding and billing practices.

Value and ROI: Mistakes and omissions can have significant revenue implications, especially for high-utilization tests. Hospitals are particularly vulnerable because charges for laboratory services must be aligned with other charges on a claim. Even a small error, such as use of the wrong revenue code, can stop the entire claims process and delay payment. Decision-makers need to balance the cost of MedLearn laboratory resources with the financial upside of being able to prevent unbilled services and denials.

Using up-to-date resources: It’s not just about the codes. They may not change a lot from one year to the next. However, laboratory services have advanced dramatically in recent years (think molecular pathology and gene-based testing), which directly impacts coding and billing. Factor in the high dollar amounts for some of these tests, coupled with prior authorization requirements, and it’s easy to understand the importance of having up-to-date guidance at your fingertips. Honestly, in this day and age, I don’t think there’s a year you can afford to not update your laboratory resources.

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