sboroughs
Contributor
During an annual wellness exam, a provider ordered a lipid panel with a hyperlipidemia diagnosis instead of the routine exam diagnosis Z00.00/01 because the patient has hyperlipidemia. The labs were not reimbursed in the manner services related to the annual wellness exam would, the payer requested charge correction to the routine diagnosis codes in order to consider them as related to the patient's annual wellness benefit. As the patient presented for the annual wellness exam and not a check on their hyperlipidemia, are we able to code the lab based on the reason for the visit, or are we bound to using the hyperlipidemia diagnosis because the patient was previously diagnosed with it?