Wiki lab billing w/medicare insurance

[JanetQ]

I am new to lab billing and i have a question.

We have pt's that come into our office as a new pt, or even as an estab. pt which then our Dr's will order labs to be done for the pt. for example a hepatitis panel. If there is no definite diagnosis code and pt has medicare are there any codes that can be billed. We have tried to bill a few diagnosis codes and have not had any luck. Any feed back would be very helpful.

diagnosis codes, diagnosis coding

 

[CodingKing]

Medicare doesn't cover routine screenings. If you want to see what DX codes are covered for specific lab tests you would have to check NCD 190. For instance Hepatitis panel its NCD 190.33

https://www.cms.gov/medicare-covera...f+Codes+Covered+by+Medicare)&bc=BAgAAAAAgBAA&

Indications and Limitations of Coverage

Indications

1.To detect viral hepatitis infection when there are abnormal liver function test results, with or without signs or symptoms of hepatitis.

2.Prior to and subsequent to liver transplantation.

Limitations

After a hepatitis diagnosis has been established, only individual tests, rather than the entire panel, are needed.

diagnosis codes, diagnosis coding