Pathology/Lab Coding Alert

Question: Which diagnosis code should I use to bill Medicare for preventive screening with CPT Codes 85025 and 80061? Would I use a V code? Texas Subscriber Answer: Codes 85025 (Blood count; complete [CBC], automated [Hbg, Hct, RBC, WBC and platelet count] and automated differential WBC count) and 80061 (Lipid panel) are for laboratory tests that a physician might order as part of a preventive exam. When he or she orders or performs a lab test for preventive or screening purposes in the absence of disease, signs or symptoms, or injuries you should use the appropriate ICD-9 V code. V codes describe patient/physician encounters that are related to health status but may not involve an illness, injury or disease process.

If the physician is screening for a specific problem, such as high cholesterol, the most specific and appropriate V code for your situation is V77.91 (Screening for lipoid disorders). Other V codes may also be appropriate with other lab codes, depending on the reason for the screening:

V20.2 (Routine infant or child health check) for screening during a well infant or child exam
V70.0 (Routine general medical examination at a health care facility) for screening performed as part of a routine checkup
V72.3 (Gynecological examination) for screening during an annual well woman exam.