I need help removing the gray area from this situation before I call the patient back.
The patient came in for their yearly male physical. He has active diagnoses of Hyperlipidemia and Hypertension. He has scripts for both things but the wife makes it sound like he is not taking any medication. Dr ordered a CMP, CBC, Lipid and PSA. The DX for the CMP and CBC was 401.9 and the DX for the lipid panel was 272.4. Of course, insurance didn't cover these labs because they were not considered routine. The wife now wants me to rebill them as routine since the patient was in for his yearly physical and he is not taking any medication.
I asked the dr to tell me specifically why he ordered the blood work and his reply to me was "routine health survallience- he does have scripts for lipid and htn however." That answer makes this delimma even more confusing.
Any insight or suggestions as to how I should handle this situation?? Leave it as is and tell the patient we cannot recode and rebill or could I change the dx of the labs to V70.0??