Diagnosis for labs for Antipsychotic Meds-NEED HELP ASAP

anne32

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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...
 
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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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mitchellde

True Blue
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For drug monitoring you should use two codes. The Z51.81 for the drug monitoring followed by the Z79 code for the drug
 
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Mobile, Alabama
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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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