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Diagnosis for labs for Antipsychotic Meds-NEED HELP ASAP

A

anne32

Guru
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103
Location
Wheatfield, IN
Medicare is denying our labs that are drawn to monitor lipids of patients taking antipsychotic medications. Currently we are coding the patients condition but is there another code we should/could be using? Any help is appreciated!! My manager is wanting a response asap and I'm at a loss on this one...
 
What codes are you billing? If you're doing labs, you have to have a reason for them. Using a mental health diagnosis wouldn't justify the need for lab work. You'd need additional information. Maybe something in Z79- for long term use of that med.
 
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If the patient is being monitored for drug therapy then I would code the Z code for the drug. Otherwise, if this is just labs for (i.e., Effexor which can lead to liver issues) I would code Z79.899 for long-term use of medications.
 
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