tci Part B Insider - 2004 Issue 7

Use the Right Diagnosis to Justify Frequent Lipid Testing

A national coverage determination from CMS (40-12) said in January that Medicare would normally cover lipid testing once per year. But Part B carrier Cigna says in its latest "frequently asked questions" list that testing could happen more often if "supported by clinical indication(s)."Cigna doesn't go into any more detail, but it's frequently reasonable to perform screening tests such as lipids more often for patients who have symptoms of heart disease, liver disease, hyperlipidemia or other conditions, says Kenneth Wolfgang, director of coding and analysis with National Health Systems in Portland, Ore. (Similarly, you can perform mammograms or...

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