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Pathology/Lab Coding Alert

READER QUESTIONS :

Zero In on Lipid Screening Guidelines

Question: Were having problems with Medicare payment for lipid screening. I thought this was one of the covered preventive services. What could be the problem? Wisconsin Subscriber Answer: You are correct that Medicare will cover lipid testing to screen patients for heart disease as a preventive service. But Medicare places plenty of restrictions on the coverage, and your billing could be running afoul of Medicares requirements in one of three areas: 1. Covered tests: Medicare will pay for one approved code from the following list: " 80061 -- Lipid panel. This panel must include the following & 82465&83718&84478 " 82465 -- Cholesterol, serum or whole blood, total " 83718 -- Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) " 84478 -- Triglycerides. Trap: If the physician orders two tests -- such as total cholesterol and triglycerides -- you cant use the panel code.But your carrier may not pay for both tests because the coverage [...]


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