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LEAD TEST CPT 80061

Patricia Posted Fri 16th of October, 2015 16:20:00 PM

I KNOW THIS HAS BEEN DISCUSSED BEFORE, BUT I AM GETTING DENIALS ON CPT 80061 WITH THESE TWO DIAGNOSIS. Z00.129 AND Z132.20. I AM AT A TOTAL LOSS. PLEASE HELP.

THANKS

SuperCoder Answered Mon 19th of October, 2015 07:07:21 AM

Hi Patricia,

The CPT code (80061) that you have mentioned here is not for lead testing and the second icd-10 (Z132.20)code is invalid code. Please provide correct information
Thanks

Patricia Posted Mon 19th of October, 2015 12:48:15 PM

Which code is allowed for screenings?

SuperCoder Answered Tue 20th of October, 2015 01:43:06 AM

Hi Patricia.

Lead Screening
CPT Code 83655 Lead

Patricia Posted Tue 20th of October, 2015 12:33:17 PM

Thanks, I just looked that up they are doing the panel. Please let me know the ICD 10 being used for the screenings. Thanks,

SuperCoder Answered Wed 21st of October, 2015 02:17:45 AM

Hi,

Z13.88 Encounter for screening for disorder due to exposure to contaminants.

Patricia Posted Wed 21st of October, 2015 18:54:07 PM

I SEE WHAT I WAS SAYING WRONG THIS IS THE CPT 80061 IS A LIPID PANEL AND THIS IS WHAT I WAS WONDERING WHY THEY ARE DENYING WITH WELL VISIT AND DIAGNOSIS CODES? SORRY FOR THE CONFUSION. I HAVE BEEN UNDER THE WEATHER AND NO OTHER EXCUSE.

SuperCoder Answered Fri 23rd of October, 2015 03:20:53 AM

Hi,

You will need to review the documentation and potentially query the provider to see what risk factors the patient had to indicate the need to perform those lab procedures. for example if the patient has hyperlipidemia, then that would support the 80061.

Otherwise, the patient should have had an ABN signed prior to the provider seeing them and the patient could be billed. If no ABN, the clinic will have to absorb the cost.

Well visit is only used for routine physical. Not all physicals require lab draws

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