Pathology Billing That Pays What You Earn
Pathology billing requires specialty expertise in anatomic pathology professional component billing, molecular pathology coding, immunohistochemistry stain billing, and the complex coordination between the pathologist's professional interpretation and the lab's technical component. Correct TCPC split billing, CPT coding for tissue level (gross, microscopic, special stains), and molecular panel reporting are all high-value and high-error-rate billing areas. 360Solutions provides pathology billing specialists who optimize professional component revenue, capture special stain billing, and manage molecular pathology coding with precision.
Where Pathology Practices Lose Revenue
These are the coding and billing pitfalls that cost pathology practices the most — and where our specialised billers add the most value.
TC/PC Split Billing
Pathologists typically bill only the professional component (modifier -26) — the technical component is billed by the laboratory. When the pathologist's group also owns the lab, global billing applies. Incorrect split application results in either overclaiming or missing professional component revenue entirely.
Surgical Pathology Tissue Level
Surgical pathology codes (88302-88309) are tiered by the complexity of the tissue examined — from simple cysts to complex tumors requiring extensive sampling. Defaulting to a lower tissue level code for every specimen rather than matching the CPT code to the specimen type and complexity leaves revenue uncaptured.
Special Stain & IHC Billing
Immunohistochemistry stains (88342 for each antibody; 88360/88361 for morphometric analysis) and special stains (88312 per stain group) are separately billable additions to surgical pathology. Many pathology groups miss stain billing entirely or bill a flat count rather than identifying each separately billable stain.
Molecular Pathology Code Complexity
Molecular pathology codes (81162-81383 for single gene; 81410-81411 for multi-gene panels) are tied to specific genes by CPT code. Using wrong gene codes or submitting unlisted molecular pathology codes (81479) instead of the specific code loses negotiated rate reimbursement.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Pathology.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
Professional component modifier -26 omitted on pathology interpretation claim
Surgical pathology tissue level understated — complexity not matched to specimen type
IHC stain count billed exceeds number of stains documented in pathology report
Molecular pathology unlisted code (81479) used when specific gene code exists in CPT
Special stain billed as Group I when performed for non-organism reason
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Pathology Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in pathology coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Pathology Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified pathology billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.