decisionhealth Newsletters, Part B News - 2002 Issue 1 (January)
Recent CMS change doesn't affect how you bill screening tests
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Article Overview
This article is for coders, billers, auditors, and compliance-focused clinicians who need to understand how Medicare guidance applies to diagnostic testing and screening services. It discusses a CMS memo, the distinction between test results and the reason a test was ordered, and the continued use of preventive medicine coding for screening-related services. The article also addresses common billing misconceptions, audit risk, and the difference between screening encounters and follow-up office visits.
Why This Topic Matters
Accurate reporting of screening and diagnostic services affects claim submission, coverage, compliance, and audit risk. The article helps readers recognize that recent CMS diagnostic-test guidance does not eliminate existing screening-test coding principles.
What You Will Learn
- How CMS guidance distinguishes diagnostic testing from screening services
- Why the reason for ordering a test matters in Medicare reporting
- How screening encounters differ from follow-up visits for newly identified conditions
- Why improper diagnosis selection can create compliance concerns
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Practice auditors
- Physicians and office staff
Codes Discussed
Code Ranges Discussed
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