Pathology/Lab Coding Alert

Acknowledge frequency and diagnosis restrictions.Medicare -- and other payers -- cover lipid screening, which could create a high test volume in your lab. That's why you need to know the ins and outs of coverage rules to make sure you're capturing all the pay you deserve. Know the TestsPhysicians may order any or all of the following tests to screen for cardiovascular disease, according to CMS:82465 -- Cholesterol, serum or whole blood, total83718 -- Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)84478 -- Triglycerides test."Note that these three tests comprise the lipid panel, so if the lab performs all three tests, you should report 80061 (Lipid panel) instead of the individual test codes," says William Dettwyler, MT AMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore. "Medicare will pay for the individual tests when ordered separately, however."From a clinical standpoint, ordering the full panel makes sense, says Ashleigh A. Raubenolt, CPC, [...]