LABS: What The New Screening Regs Mean For Labs

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers proposed Medicare screening policy changes that affect how laboratories document and bill certain preventive lab tests in 2005. It focuses on the general types of screening guidance, documentation expectations, and coverage considerations for diabetes and cardiovascular testing, making it relevant to laboratory billing staff, coders, and compliance teams working with Medicare claims.

Why This Topic Matters

The article helps readers understand how evolving screening coverage rules can affect whether lab claims are paid and what type of diagnosis support may be needed. It is especially relevant for labs that bill Medicare for preventive testing and need to align documentation with screening coverage requirements.

What You Will Learn

  • How proposed Medicare screening rules may affect laboratory reimbursement
  • How screening-related documentation differs from diagnostic testing documentation
  • Which general patient factors are discussed in relation to screening eligibility
  • How frequency limitations may affect screening test coverage
  • How cardiovascular screening lab claims are discussed in relation to diagnosis reporting

Who Should Read This

  • Laboratory billing staff
  • Medical coders
  • Compliance professionals
  • Physician practice billing staff
  • Health information management professionals

Codes Discussed

  • ICD-9-CM: V77.1
  • ICD-9-CM: 783.5
  • ICD-9-CM: 788.41
  • ICD-9-CM: 278.00
  • CPT: 82947
  • CPT: 80061

Code Ranges Discussed

  • ICD-9-CM: 402.00-402.91

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