Pathology/Lab Coding Alert

Question: We received an order for a screening lipid profile, but the ordering physician indicated that the patient had hyperlipidemia. Should we use the screening or hyperlipidemia diagnosis?

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Answer: Because the physician has already established the diagnosis of hyperlipidemia, you should use the available definitive diagnosis: hyperlipidemia (272.4, Other and unspecified hyperlipidemia). You should code the most definitive diagnosis, according to ICD-9 guidelines.

Use a screening diagnosis, such as V77.91 (Screening for lipoid disorders) when the physician orders the panel in the absence of signs, symptoms or definitive diagnosis.

Report the lab test as 80061 (Lipid panel). Dont forget to append modifier QW (CLIA waived test) if youre a CLIA waived lab.

-- Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of DoctorsAnatomic Pathology services in Jonesboro, Ark.