Cardiology Coding Alert

Question: We perform our own lipid screening, and we're having problems with Medicare payment. I thought this was one of the covered preventive services. What could be the problem? Wisconsin Subscriber Answer: You are correct that Medicare will cover lipid testing to screen patients for heart disease as a preventive service. But Medicare places many restrictions on the coverage, and your billing could be running afoul of Medicare's requirements in one of three areas: 1. Covered tests: Medicare will pay for one approved code from the following list: • 80061 -- Lipid panel. This panel must include the following ... 82465...83718...84478 • 82465 -- Cholesterol, serum or whole blood, total • 83718 -- Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) • 84478 -- Triglycerides. Trap: If the physician orders all three tests, Medicare will pay for the lipid panel (80061). But if the physician orders two of the tests -- such as total cholesterol [...]