Part B Insider (Multispecialty) Coding Alert
Reader Question:
Labs Must Have Specific Orders on File
Published on Thu May 17, 2012 
PDF
PDF
Question:
Answer:
CVD markers refer to lab tests that could be an indicator for cardiovascular disease. The term does not encompass a specific test or set of tests, however, so you could not accurately perform lab tests or bill for them based on this information alone.The lab should contact the cardiologist to get specific orders for the desired tests. For instance, the physician might request a brain natriuretic peptide (BNP) test for a patient with chest pains to evaluate the prognosis of a current cardiovascular event. If the lab performs BNP, you would bill 83880 (Natriuretic peptide).
The cardiologist might also order a C-reactive protein (CRP) test to evaluate inflammation that's related to heart disease risk. If the lab performs that test, you should report 86140 (C-reactive protein).
Bottom line:
The term "CVD markers" does not provide enough specific information for ordering or billing lab tests. Once you ascertain the specific tests that the cardiologist orders for the patient, you should bill the lab tests accordingly.Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- Part B Mythbuster:
Mid-Level Providers Can Help With the Tough Cases
Using your non-physician practitioners only for the simple visits could cost you.Myth: Mid-level providers (MLPs) [...] - Modifiers:
Refresh Your Modifier 57 Knowledge to Keep Reimbursement Flowing
Hint: Avoid using 57 for minor procedures.In these tough economic times, every dollar counts--and if [...] - ICD-10:
Use This Map to Navigate Your ICD-10-CM Manual
We've got the tips you need to make sense out of the new diagnosis coding [...] - Part B Coding Coach:
Consider Urinalysis Method Before Selecting From 81000-81003 Series
Be sure you have the right code, whether you test for 1 element or all [...] - Physician Note:
EMR Signature Must Translate to Printed Copy, One Medicare Contractor Says
Plus: CMS Approves "Check Box" for Physician's Home Health DocumentationElectronic medical records (EMRs) can be [...] - In other news
Medicare has finally loosened up on some unnecessarily strict documentation requirements for face-to-face encounters with [...] - Reader Question:
Avoid 79101 on 78452 Claim
Question: Why am I getting denials for radiopharmaceutical injection (79101) with MPI (CPT 78452 [...] - Reader Question:
Know Nerve Injected Before Billing
Question: Our physician administers a lot of steroid injections and injections of anesthetic for patients [...] - Reader Question:
Labs Must Have Specific Orders on File
Question: A cardiologist ordered "CVD markers" for a patient presenting with chest pain. What test(s) [...]
View All