Everything You Need to Know About Pathology Codes in Medical Billing

Touseef Riaz

April 7, 2023

pathology codes in medical billing


Pathology codes in medical billing

Medical billing is the process of recording, processing, and paying out medical services rendered to patients. Medical billing can be complicated and take much time if not done correctly. When handling medical claims, you may have a lot of information to keep track of. It can be overwhelming sometimes, and there may appear to be no feasible way to get ahead in your career or life. 

pathology codes in medical billing

Medical billing can be a tricky business. There are so many rules and regulations to follow. It can seem like a maze that always continues. However, the only way out is to know the rules, how they work, and how to make your job easier.

Pathology codes are a unique way of identifying specific diseases and conditions. There are currently over 1,100 pathology codes available. These codes are used for diagnosis and treatment purposes. The more complex the diagnosis, the more codes you’ll need to code. Some treatments are less specific than diagnoses. Thus, you can use standard generic terms. 

Sometimes, multiple codes for a single diagnosis or procedure will be used. Pathology coding differs from another medical coding because it requires a more detailed understanding of medical terminology. Pathologists and medical coders use pathology codes. These codes help to ensure accurate and complete medical billing. Besides, these codes help ensure the practitioner is correct in their services.

ICD-10 has developed a list of CPT  Pathology codes in medical billing. The codes are broken down into corresponding alphabetic sections. Most of which fall into an appropriate category with only a few exceptions. 

What are Pathology codes in Medical Billing?

Pathology codes identify the specific disease, pathophysiological process, condition causing symptoms, diagnosis, or treatment for an individual patient. They use it as part of the diagnosis code (ICD-9), procedure code (ICD-9), and procedure modifier(s).

Pathology codes are a unique way of identifying specific diseases and conditions.

There are currently over 1,100 pathology codes available for diagnosis and treatment purposes. Several subcategories of each principle can be used to refine your search further. Pathology codes describe a patient’s medical condition. Physicians often use them to bill for their services. They’re essential. Because they can help determine your health insurance coverage. How much you’ll have left after completing treatment?

Pathology codes fall into three categories: anatomic pathology, clinical pathology, and genetic pathology. Each type has different rules. These rules must be followed when documenting the results of patient tests.

The more complex the diagnosis, the more codes you’ll need to code. And it’s more than just the complexity of the problem that determines how many regulations you’ll need. It’s also how much time has passed since treatment began and whether or not that treatment was covered by insurance.

For example, if you’re treating someone with an infection caused by strep throat (strep). This infection can cause tonsillitis and pneumonia in most cases. But, it can also lead to sepsis (blood poisoning) if left untreated. Thus, this person needs antibiotics right away. You’ll likely use two different ICD-10-CM codes: one for strep throat and another for sepsis.

How do pathology codes work in medical billing?

To understand how pathology codes in medical billing work, first, you need to know that the health care system uses them to identify a disease or condition of a patient.

The Centers for Medicare & Medicaid Services and other designated bodies are the CMS. The code is an alphanumeric string assigned by CMS. Your hospital will use these codes to report on your billings. Thus, they can receive reimbursements when paying out to insurance companies.

If you run a medical practice, you know how important it is to keep your bills accurate and on time. But with so many different players in the healthcare industry, it can take time to stay on top of them. That’s why pathology billing services are so helpful! Pathology billing services let medical professionals track claims quickly and accurately through their platform instead of waiting for insurance companies or auditors to respond.

Benefits of Pathology Medical Billing Services

Easier to Follow

  • There are numerous benefits to using Pathology billing codes.
  • These codes are more accurate.
  • These codes provide faster services.
  • Pathology billing codes are more convenient.

Faster Payment

  • Pathology billing services can help you get paid faster.
  • You can get paid more for your work.


It can be stressful and time-consuming if you need help with your pathology codes in medical billing. But there are ways to ensure you get paid on time—one is pathology billing services! Pathology billing services are a great way to keep your medical claims accurate and timely. The reason is simple: pathology billing services are more accurate than you can be. They also follow the correct coding guidelines, meaning you get paid faster and save money in the long run.

Increase Revenue

Medical billing services can help you reduce costs, improve revenue, and ensure patients get the necessary care. However, it’s essential to know that medical billing services are not just about making sure your patients pay their bills–they’re also about helping them understand their insurance coverage and getting the treatment they need.

You can get your invoices paid on time, so you don’t have to worry about money being held up or lost due to late payments. You can save money on paper and toner by not having to print out each bill individually. It can also keep costs down when it comes time to invoice your patients. You can easily track payments, making sure they’re all getting paid appropriately. If someone owes you money but has yet to pay, you’ll know so you can take action.

Save Time

Medical billing services are a great way to streamline your office’s workflow and save time. When you use these services, you can focus on the things that matter most–like ensuring your patients get the care they need. They help you avoid mistakes by knowing exactly what happens during each appointment. These services make it easy for patients to pay their bills because they can do it online or over the phone. These services are good for business because they allow you to track your patient’s medical records in one place.

What kind of details are you seeking when searching for a code?

When searching for a pathology billing code, it is crucial to have information about the patient, such as the patient’s name, date of birth, and service date. Moreover, the pathology service provider’s name and the specific pathology type are being billed. Therefore, it is also essential to have the diagnosis code. Besides, any supplemental information is needed to bill the service accurately.

Additionally, it is essential to understand the type of pathology billing and the corresponding code that should be used. Knowing the payment policies and rules associated with the specific pathology code is also necessary for the most accurate reimbursement. Several aspects need to be considered when you’re looking up a code. 

How do you know if the lab’s report matches the code?

When you receive a lab report, the results are usually listed in one of two ways: as an insurance claim number or a code. The latter is what you’ll see in your medical billing software. You need to know how these codes work and how they relate to the original diagnosis to understand each step of treatment.

To ensure that the lab report matches the code, it is essential to review both the lab report and the code. First, ensure that the data collected, the variables used, and the conclusions drawn all match up. One way to do this is to assign each variable a unique identifier. That identifier reference is in both the code and the lab report. Second, verify that the code calculations and the lab report calculations match. Additionally, it is essential to double-check any conclusions drawn from the code. Besides, the lab report too.

Can I get an earlier claim date?

Yes, you can get an earlier claim date. There are two ways to do this:

An online appeal form will allow you to request a new claim date up to 90 days before the current one expires. This option is only available if you claim between January 1 and April 30 this year.

You can also call the customer service line. You can ask them about an appeal or submit a ticket through their website. They will then review your case. Then, they determine if there is any way they can accommodate your needs without making any changes in their process or systems, as long as it doesn’t impact patient care!

Different Types of Pathology Codes in Medical Billing

Pathology codes in medical billing are used to document the results of diagnostic tests. They’re called “pathology” because they describe what’s found in a patient or sample rather than how it got there. For example, the first character of each pathology code tells you whether or not it was done on an outpatient basis. In contrast, the second character indicates whether or not any follow-up testing was needed afterward.

A pathology code is a six-digit number that represents various medical procedures or tests. It’s used by doctors and hospitals when billing insurance companies, so you’ll see them on your bills. Pathology codes are essential. But some things can help you understand what they mean.

Each code is composed of five digits. For example, one of the most common pathology codes is 82465, which is used for cholesterol testing. triglycerides CPT code 84478, and HDL cholesterol CPT code 83718.

Different Types of Pathology Codes 

There are two pathology codes in medical billing based on laboratory test methods.

The ICD-10, or International Classification of Diseases, is a list that groups diseases by symptoms and signs rather than by body systems or organs. The ICD-10 code identifies the type of test performed and the laboratory’s method for testing it. For example, if a lab uses an automated blood clotting method, they use an ICD-10 code like “2060.”

CPT: The Current Procedural Terminology (CPT) is used by hospitals to describe how they do procedures in writing forms like insurance claims. It represents each step with specific terminology such as “excision” or “ligation” so doctors can bill appropriately for services rendered during surgery procedures at their hospital.

Speech Pathology CPT Codes

Some speech pathology codes are listed below:

92507 Treatment of speech, language, voice, communication, and auditory processing disorder; individual.

92520 Laryngeal function studies.

92521 Evaluation of speech fluency (e.g., stuttering, cluttering).

92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria) https://neolytix.com/speech-therapy-medical-billing-coding/

CPT Codes Billing Pathology Codes for Excision

CPT codes for pathology excision are divided into two main categories, excision of a benign lesion and excision of a malignant lesion. The code range for each type is listed below:

In the excision of a benign lesion, the CPT codes range between 11400—11471.

Excision of malignant lesions: 11600—11646.



Pathology codes are a set of codes used in medical billing to specify the type and nature of the services provided by a pathology practitioner. Healthcare providers use these codes to accurately and efficiently bill their services. Pathology codes in medical billing are part of the ‘ICD’ code system, an international code system used by pathology practitioners. Pathology codes are long, complex, and highly specific, and each code is unique. Common examples of pathology codes include specimen collection, analysis, and diagnosis of various diseases and conditions.

U Control Billing’s team understands how hard it can be to track down every detail of your claim. Therefore, our team has made it their mission to help small businesses like yours and large organizations like hospitals. Our experts will walk you through everything from start-up costs through ongoing reporting and payment processing so that no matter what size of business or organization needs our help, we’ll always be there for them!


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