Level and specimen errors
Surgical pathology billed at the wrong level or specimen count. Coded from the report.
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Pathology medical billing services
Pathology billing separates technical and professional components across surgical pathology levels, special stains, immunohistochemistry and molecular tests, each with unit rules and medical-necessity policies. Lab billing compliance — including the rules on who may bill — is central.
What makes pathology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether pathology claims pay the first time.
- Surgical pathology codes (88300–88309) are leveled by specimen type, and multiple specimens are billed per specimen with documentation.
- Special stains (88312–88314) and immunohistochemistry (88342, 88341) are billed per stain or antibody with payer limits per specimen.
- Technical and professional components are billed by the lab and the pathologist respectively, or globally where the same entity does both.
- Molecular and genetic tests face prior authorization and coverage policies that vary widely.
Denials we see most in pathology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Stain unit limits
IHC and stains denied over payer limits. Limits applied per specimen.
Component misassignment
TC and 26 billed incorrectly. Mapped per arrangement.
How Core MB bills for pathology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new pathology providers runs in the same system, tracked live in your client portal.
- Specimen-level coding from the pathology report.
- Stain and IHC unit management per payer.
- Component billing mapped to lab arrangements.
Everything in the service
The full revenue cycle as standard for pathology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Pathology billing questions
How is surgical pathology leveled?
By specimen type, under a system that assigns each specimen to a level. Multiple specimens are billed separately with documentation.
Are there limits on immunohistochemistry billing?
Yes. Payers limit stains per specimen and have specific unit rules, which we apply.
Who bills the technical component in pathology?
The lab that processes the specimen; the interpreting pathologist bills the professional component, unless one entity bills globally.
How do we get started with Core MB for pathology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new pathology providers can start at the same time.
More in diagnostics
Find out what your pathology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.