Internal Medicine Coding Alert

If your physician performs all three tests on the same day, you should use 80061 (Lipid panel) because this lipid panel code includes the tests.

Special note: Codes 80061, 82465, 83718 and 84478 represent waived-status tests. That means as long as your internist has a "waived status" Clinical Laboratory Improvement Amendments (CLIA) certification, he can perform the tests in the office. Just remember to attach modifier -QW (CLIA waived test) to the codes, LeFlore says.

Heads-up: If your internist doesn't perform the lab test or doesn't have the CLIA certification, you cannot report the lab codes. Instead, you'll have to use the appropriate E/M codes (99201-99215) as long as the documentation supports billing an office visit, Collins says.

2. Tie In the Correct ICD-9 Codes

Because these are screening tests, you should use screening V codes as your primary diagnoses, Medicare says. Be sure to use the following approved codes: 

How it works: Suppose your internist orders the cholesterol test for high-density lipoproteins to screen for hypertension. In that case, you would link V81.1 to 83718.

3. Don't Throw Away That ABN

Although your office knows that Medicare will pay for the cardiovascular screenings only once every five years, your patients may forget. That means you should develop an advance beneficiary notice (ABN) process for your patients, Collins says.

Example: A physician checks a patient's cholesterol this year. Two years later, the patient sees your physician for a cardiovascular blood screening.

If the patient doesn't tell your physician about the previous screening, then you'll be unprepared for Medicare's denial and may have to write off charges for the lab tests.