Laboratory billing denials can significantly impact revenue, especially when CPT coding errors or incomplete documentation are involved. To ensure consistent reimbursements, laboratories must strengthen their billing and coding accuracy.

Here are key strategies to avoid denials in laboratory CPT billing:

Ensure Accurate CPT Code Usage Verify that all laboratory procedures are assigned the correct and most recent CPT codes. Outdated or incorrect codes often trigger automatic denials.

Link Diagnosis Codes Properly Pair each CPT code with an appropriate ICD-10 code that clearly supports medical necessity. Review Medicare’s coverage database for current policy updates.

Document Medical Necessity Clear, detailed clinical documentation is crucial. Missing physician orders or inadequate notes can cause immediate claim rejections.

Monitor Denial Trends Track recurring denial reasons to identify problem areas in your billing process. Proactive analysis helps reduce repeated coding or claim errors.

Outsource for Accuracy Partnering with experts like AnnexMed’s Laboratory Billing Team ensures claim precision, compliance, and faster reimbursements.