Wiki Valid icd9

[HBULLOCK]

I work in a Pediatric office so I'm not sure how to bill these lab tests. Patient came in for her yearly physical, 20 year old w/Medicare. She had 85025/82465/83718. I have tried several diags but they are all kicking out of my edits. I have used v70.0, v77.91, and v81.2 and they are are incorrect per edit. Anyone know which dx I should use for these labs? Thanks

 

[dclark7]

Medicare does not cover yearly physicals, this is statutatorily excluded from coverage. Medicare will deny and the patient or their secondary insurance would be responsible. Medicare does have their welcome to Medicare exam which must be done when the pateint first becomes eligible and then they have their Annual Wellness Exam which is not really a physical it's more of a health assessment (fall risk, phsych, etc) geared for the elderly and not younger patients.

 

[Cynthia Hughes]

The Medicare preventive service quick reference indicates that the cardiovascular screening blood tests are covered every 5 years for patients who are asymptomatic of cardiovascular disease. Valid ICD-9-CM codes are V81.0, V81.1, and V81.2. A screening CBC would not be a covered service. If the physician indicated a diagnostic reason for the test see the Medicare laboratory coverage NCD's at http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/LabNCDs.html.

 

[HBULLOCK]

Thanks ladies for the response!