decisionhealth Newsletters, Part B News - 2007 Issue 9 (September)
Mantoux (part two): PPD not always a must
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Article Overview
This article discusses Medicare coverage considerations for tuberculosis skin testing and the follow-up visit to read the result. It is aimed at coders, billers, and primary care practices that need general guidance on when this type of testing is discussed in relation to exposure history and screening claims. The article also references how CMS, carriers, and the American Academy of Family Physicians are discussed in the context of billing and payment for the testing process.
Why This Topic Matters
Tuberculosis screening and follow-up billing can be denied or paid differently depending on the documented reason for the test and the related visit. Understanding the article helps practices recognize the broader Medicare coverage issues surrounding this common preventive and diagnostic service.
What You Will Learn
- How the article frames Medicare coverage issues for tuberculosis skin testing
- What broad factors are discussed in connection with medical necessity for the test and the follow-up visit
- How the article places CMS guidance and physician organization commentary in context
- How exposure history and screening are discussed as separate billing considerations
Who Should Read This
- Medical coders
- Billing staff
- Family medicine practices
- Primary care clinicians
- Compliance staff
Codes Discussed
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