Pathology/Lab Coding Alert

Question: Which glucose tests will Medicare cover for diabetes screening, and how should I code the service? Arkansas Subscriber Answer: You should instruct physician clients that Medicare requires V77.1 (Special screening for diabetes mellitus) as your primary diagnosis when ordering a diabetes screening glucose test for low-risk patients. Medicare will cover one of three tests for diabetes screening each year: the fasting blood glucose test, the post-glucose challenge test, or the glucose tolerance test. To code the fasting blood test, you should assign 82947 (Glucose; quantitative, blood [except reagent strip]). The post-glucose test requires 82950 (... post glucose dose [includes glucose]), and the glucose tolerance requires 82951 (... tolerance test [GTT], three specimens [includes glucose]). Medicare pays for only one test, so you should submit only one of the above codes. Don't miss: For high-risk patients who exhibit "prediabetes," physicians can order the screening test twice a year. Medicare requires [...]