Pathology & Laboratory medical billing and coding services
Panel unbundling risk, medical necessity and PAMA reporting. Medxcode codes, bills and appeals pathology & laboratory claims with specialty-trained staff — 99% first-pass acceptance and an average of 42 days in A/R.
-36%
Necessity denials
99%
First-pass acceptance
50
States covered
Where pathology & laboratory revenue actually leaks
Pathology & Laboratory claims fail for reasons that have nothing to do with clinical quality. The denials cluster around a handful of documentation, coding and authorization patterns — and once you know which ones, they stop being inevitable. These are the three we correct first in almost every pathology & laboratory engagement.
- 01
Panel versus individual test billing compliance
- 02
Medical necessity documentation from ordering providers
- 03
Molecular and genetic test authorization
Codes our pathology & laboratory coders live in
Your account is staffed by coders who work pathology & laboratory every day, not generalists rotating through specialties. That means the code families below are familiar territory, along with the payer-specific edits that surround them.
88305, 80053, 81001, 87591, 0016M
How we run a pathology & laboratory account
Packages
Pathology & Laboratory billing packages
Same packages, staffed with pathology & laboratory coders. Managed service fees start at 3.99% of monthly collections, month-to-month with no setup fee.
Starter
3.99%
of monthly collections
Solo providers under 500 claims per month
- Eligibility verification and charge entry
- Claim scrubbing and electronic submission
- Payment posting and patient statements
- Rejection correction and refiling
- Monthly performance report
- Month-to-month. No setup fee. No long-term lock-in.
Growth
3.99%
of monthly collections
Practices billing 500–2,000 claims per month
- Everything in Starter
- Dedicated billing team and named lead
- Full denial management and appeals
- Aged A/R recovery included
- Coding review by certified coders
- Weekly KPI dashboard and monthly review call
Enterprise
Custom scope
proposal based on volume and scope
Multi-site groups above 2,000 claims per month
- Everything in Growth
- Multi-location and multi-TIN billing
- Credentialing and compliance audits bundled
- EHR / clearinghouse integration support
- Custom analytics and payer scorecards
- Quarterly executive business review
Calculator
Estimate recoverable pathology & laboratory revenue
Medical billing revenue calculator
Estimate the collections you would recover by moving to a 99% first-pass, 24-hour submission billing workflow.
Total claims submitted each month across all providers.
Average allowed amount per claim.
Share of claims denied or rejected on first submission.
Projected additional annual collections
$182,892
Estimated annual revenue recovered by moving to a 99% clean-claim workflow
- Monthly billed charges
- $432,000
- Revenue lost to denials today
- $21,168 / month
- Projected monthly recovery
- $15,241
Estimates use benchmark recovery rates from comparable US practices. Your written analysis replaces these estimates with numbers from your own payer mix.
Services
Specialties