# Tb screening



## NMURPHY8366

Hello; can someone tell me what diagnosis to use for a TB screening done by chest X-Ray. I used the V74.1 which is not payable by Medicare.


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## sspain

I am not aware that Medicare pays for ANY tuberculosis screening.  If the patient has symptoms and needs a diagnostic evaluation to rule out TB, then code the symptoms (cough, fever, weight loss, etc) or the working diagnosis.  If someone had contact with or exposure to tuberculosis, the code would be V01.1, but I still doubt that Medicare covers that screening.


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## csandri

*TB screening*

In South Carolina medicare will pay for TB screening,, the first test using V74.1 as a second diagnosis, we use another condition that the patient has as the primary diagnosis and get paid.


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## sspain

There is a distinction between screening and diagnostic testing.  

Certainly, if TB is a possible diagnosis that needs to be evaluated, then TB testing is covered.  However, if one is simply screening for TB (out of curiosity, or for employment reasons, for example, and in the absence of signs, symptoms, or increased risk of disease, i.e. exposure to TB) then it would not likely be covered.

If you review the CMS Guide of Medicare Preventive Services, you won't find a provision for TB screening.


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