Molecular Pathology EHR and AI Medical Billing Software

Molecular pathologists interpret DNA and RNA tests that guide cancer and inherited disease care. XEHR files interpretations and supports the approvals these tests need.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Lung adenocarcinoma; tumor testing for targetable mutations.

C34.90 Malignant neoplasm of lung

ReviewSign note

Diagnosis carried to the claimC34.90

THE HARD PARTS

What makes molecular pathology billing hard

Tests behind approvals

Many molecular tests require prior authorization with documented clinical need and how the result will change care.

Interpretation is the product

Clinicians act on the written interpretation, and for some tests it is the billable professional service.

Many teams need the report

Oncology, genetics and surgery all need the result in their record.

WHERE THE WORK HAPPENS

How molecular pathology care is delivered and billed

Molecular genetic pathologists work in hospital and reference molecular labs. The laboratory bills most tests; some molecular tests require a professional interpretation billed by the pathologist. Payers apply strict coverage rules and prior authorization to many genetic and tumor tests.

What payers check on molecular pathology claims

Many molecular tests require prior authorization with documented clinical need.
Only some molecular tests have a separately billable professional interpretation.
Tumor testing uses the cancer diagnosis; inherited testing uses susceptibility or family history codes.
Laboratories may bill only for tests their certification covers.
Inherited testing should have documented consent.

Common molecular pathology diagnoses ICD-10-CM

C34.90	Malignant neoplasm of unspecified part of unspecified bronchus or lung
C18.9	Malignant neoplasm of colon, unspecified
C92.00	Acute myeloblastic leukemia, not having achieved remission
Z15.01	Genetic susceptibility to malignant neoplasm of breast
Z80.0	Family history of malignant neoplasm of digestive organs
Z13.79	Encounter for other screening for genetic and chromosomal anomalies

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A molecular pathology visit, start to payment

1
Confirm approval

The order and any prior authorization are checked.
2
Test and interpret

Results are interpreted in a written report.
3
Report

The report reaches the treating teams.
4
Bill

Interpretations go out as professional services where billable.

How XEHR helps

From the molecular pathology visit to the payment

Approvals preparedRequests are built from the diagnosis and the ordering note.
Interpretations filedReports are filed to the patient and the ordering provider.
Shared with care teamsReports are visible to the patient’s treating teams.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for molecular pathology

AI medical billing for molecular pathology practices

XEHR is an agentic EHR: AI agents do the administrative work around every molecular pathology visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Many molecular tests require prior authorization with documented clinical need.
Only some molecular tests have a separately billable professional interpretation.
Tumor testing uses the cancer diagnosis; inherited testing uses susceptibility or family history codes.
Laboratories may bill only for tests their certification covers.

Around the visit

Agents run on their own

Coverage checked before each molecular pathology visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a molecular pathology EHR

Ask every vendor, including us. The answers show whether a system was built for molecular pathology work or only adapted to it.

Ask us on a demo

Are prior authorizations prepared for molecular tests?
Are interpretations filed and billed where billable?
Do reports reach oncology and genetics?
Is consent documented for inherited testing?
Are tumor and inherited tests coded differently?

QUESTIONS

Molecular Pathology practices ask us

Does XEHR support molecular pathology?

Yes. Interpretations, approvals and reports are documented and billed.

Can XEHR prepare approvals for molecular tests?

Yes. Requests are prepared from the diagnosis and ordering note.

Can reports reach oncology?

Yes. Reports are filed to the patient record oncology uses.

Is inherited testing handled differently?

Yes. Consent and genetic counselling are documented for inherited testing.

Does XEHR support hospital molecular labs?

Yes. Interpretations and reports are documented.

Can results be trended over time?

Yes. Results are kept in the patient record.

Can genetic counselling referrals be sent?

Yes. Referrals go from the same record.

How much does XEHR cost for a molecular pathology practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a molecular pathology practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for molecular pathology

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

Book a demo See pricing