Re: Medicare billing inquiry today? Send the money back!

[Guest guest]

did complete preventive physcial on medicare patient. She was paid $104. Patient requested cholesterol screening for which medicare denied claim for V70.0. We billed patient $40. Patient paid 144 total for physical and lipid panel.

Medicare called and inquired about the payment. Asked us to return money because lipid panel was not indicated by the V70.0 code and no ABN was signed?\

We will send the patient the $40. How do we avoid this get ABN on everyone?

To: Sent: Thu, February 18, 2010 8:31:29 AMSubject: Re: freezy stuff

I bought the Brymill cryo unit et al at the AAFP convention in Boston in October. I think I got a better deal on the equipment because I bought it then. I may still have the business card for the rep if anyone is interested. Since October, I treated about 10 patients for actinic keratoses and skin tags. I have not checked reimbursements. AllaSolo Family PracticeTravel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | fax | www.travelclinicsof america.com> > >> > >> > >> > >> > >> > >> > > This is not an ad. This is simply a link to the Welch Allyn website where> > they are giving away a box of speculums and a lighting source and charger. I> > just got mine in the mail. I can't figure out how they can afford to give it> > away unless they are really marking up the disposable speculums that much> > but thought I would pass it along in case anyone else may be interested.> > >> > >> > >> > >> > >> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA- KleenSpec- FreeOffer. html> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > > --> > > Sangeetha Murthy M.D> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >>

> >> > >> > >> > >> > >> > >> > > ____________ _________ _________ _________ _________ _________ _> > > Hotmail: Powerful Free email with security by Microsoft.> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/> > >> >> > > >>

[Guest guest]

We've talked about this before -- as Kathy mentioned below -- certain codes are supposed to be covered for preventive testing and Medicare.

 

Although, I believe there was also a discussion recently about how Medicare (or maybe it was private insurance) didn't pay for a test that was appropriately ordered with one of the codes listed and was denied -- or at least the lab said so and billed the patient.

 

Anyway...see below and the attached.

 

 

 

 

 

 

 

 

 

I’m not sure what V81.0 is but believe it or not, screening for cardiovascular disease is covered by Medicare to justify a lipid pane.  I would search for those codes that will “cover” what you order so patient is not responsible.  If it is something patient wants that you don’t think is indicated, get the ABN.  By the way, preventative physicals are not covered by Medicare.  Don’t know how you got paid for that.

 

 

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

1 of 1 File(s)

MPS_QuickReferenceChart_1.pdf

[Guest guest]

Thanks all,

I keep a coding file in email of all the suggestions from over the years but I seem to have missed the one on screening for cardiovascular disease. I really haven't had that many denied codes over the years. Except this year the hospital where I do 99% of my testing is calling almost every day requesting a different icd-9 for the tests I run. Is there a website that you all use for what codes medicare pays for at hospital and commercial labs.

No medicare did not pay for the physical. The patient paid last fall for both physical and lipid panel. She initiated a billing inquiry with medicare because medicare sent eob saying test was not medically necessary. Our WPS contractor called yesterday stating to repay or she would take it out of our billings to send to patient.

I will rebill medicare and refund patient.

Again thanks

To: Sent: Tue, February 23, 2010 6:14:44 PMSubject: RE: Medicare billing inquiry today? Send the money back!

I’m not sure what V81.0 is but believe it or not, screening for cardiovascular disease is covered by Medicare to justify a lipid pane. I would search for those codes that will “cover†what you order so patient is not responsible. If it is something patient wants that you don’t think is indicated, get the ABN. By the way, preventative physicals are not covered by Medicare. Don’t know how you got paid for that.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of PierceSent: Tuesday, February 23, 2010 7:04 PMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] Medicare billing inquiry today? Send the money back!

Why can't you resubmit the claim with the correct code (V81.0)?

did complete preventive physcial on medicare patient. She was paid $104. Patient requested cholesterol screening for which medicare denied claim for V70.0. We billed patient $40. Patient paid 144 total for physical and lipid panel.

Medicare called and inquired about the payment. Asked us to return money because lipid panel was not indicated by the V70.0 code and no ABN was signed?\

We will send the patient the $40. How do we avoid this get ABN on everyone?

From: Alla <allakirschyahoo (DOT) com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Thu, February 18, 2010 8:31:29 AMSubject: [Practiceimprovemen t1] Re: freezy stuff

I bought the Brymill cryo unit et al at the AAFP convention in Boston in October. I think I got a better deal on the equipment because I bought it then. I may still have the business card for the rep if anyone is interested. Since October, I treated about 10 patients for actinic keratoses and skin tags. I have not checked reimbursements. AllaSolo Family PracticeTravel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | fax | www.travelclinicsof america.com> > >> > >> > >> > >> > >> > >> > > This is not an ad. This is simply a link to the Welch Allyn website where> > they are giving away a box of speculums and a lighting source and charger. I> > just got mine in the mail. I can't figure out how they can afford to give

it> > away unless they are really marking up the disposable speculums that much> > but thought I would pass it along in case anyone else may be interested.> > >> > >> > >> > >> > >> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA- KleenSpec- FreeOffer. html> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> >

>> > >> > > --> > > Sangeetha Murthy M.D> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > >> > > ____________ _________ _________ _________ _________ _________ _> > > Hotmail: Powerful Free email with security by Microsoft.> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/> > >> >> > > >>

[Guest guest]

V77.91 is the code for Special Screening for Lipoid

Disorders Screening cholesterol level; Screening for hypercholesterolemia;

Screening for Hyperlipidemia

V77.1 is the code for Special

Screening for Diabetes Mellitus

V77.8 is the code for Special

Screening for Obesity

V76.51 is the code for Special

Screening for Malignant Neoplasm of Colon

V74.1 is the code for Special

Screening Examination for Pulmonary Tuberculosis

V78.0 is the code for Special

Screening for Iron Deficiency Anemia

V78.1 is the code for Special

Screening for Other and Unspecified Deficiency Anemia

V79.0 is the code for Special

Screening for Depression

V79.1 is the code for Special

Screening for Alcoholism

V80.1 is the code for Special Screening for

Glaucoma

V81.1 is the code for Special

Screening for Ischemic Heart Disease

V82.81 is the code for Special

Screening for Other Specified Conditions, Osteoporosis

V82.71 is the code for Special Screening for

Genetic Disease r Status

Hope

these screening codes help some of you with your screening exam coding.  These

are the major ones I use at my practice every day.

Beth Sullivan, DO

Ridgeway Family Practice

Commerce, GA  30529

From:

[mailto: ] On Behalf Of Egly

Sent: Tuesday, February 23, 2010 7:00 PM

To:

Subject: Re: Medicare billing inquiry today? Send

the money back!

did complete preventive physcial on medicare

patient. She was paid $104. Patient requested cholesterol screening for

which medicare denied claim for V70.0. We billed patient $40. Patient

paid 144 total for physical and lipid panel.

Medicare called and inquired about the payment. Asked

us to return money because lipid panel was not indicated by the V70.0 code and

no ABN was signed?\

We will send the patient the $40. How do we avoid this

get ABN on everyone?

From: Alla

To:

Sent: Thu, February 18, 2010 8:31:29 AM

Subject: Re: freezy stuff

I bought the Brymill cryo unit et al at the

AAFP convention in Boston in October. I think I got a better deal on the

equipment because I bought it then. I may still have the business card for the

rep if anyone is interested.

Since October, I treated about 10 patients for actinic keratoses and skin tags.

I have not checked reimbursements.

Alla

Solo Family Practice

Travel Clinics of America

6559 Mills Road, Suite 107, Mayfield Village, OH 44143

| fax | www.travelclinicsof america.com

> > >

> > >

> > >

> > >

> > >

> > >

> > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > they are giving away a box of speculums and a lighting source and

charger. I

> > just got mine in the mail. I can't figure out how they can afford to

give it

> > away unless they are really marking up the disposable speculums that

much

> > but thought I would pass it along in case anyone else may be

interested.

> > >

> > >

> > >

> > >

> > >

> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA-

KleenSpec- FreeOffer. html

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > Sangeetha Murthy M.D

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > ____________ _________ _________ _________ _________ _________ _

> > > Hotmail: Powerful Free email with security by Microsoft.

> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/

> > >

> >

> >

> >

>

[Guest guest]

The

following is copied from the current Medicare NCD on lipid screening.  Note the

sections highlighted below.  According to the Medicare website the screening

for cardiovascular disease codes are only payable for a lipid panel if it is

done in conjunction with other cardiovascular procedures such as

echocardiogram, stress tests and holter monitors.  Done solely as a screening

test alone it is not covered.  Medicare only covers screening lipids with the

screening lipid code when done in conjunction with the initial Welcome to

Medicare Exam.  If not done during the follow up from the initial exam it is

considered a non-covered service and an ABN is needed in order to get it paid. 

That being said there are 424 diagnoses for other conditions that Medicare

considers to be acceptable to justify a lipid panel.  I suspect the reason they

denied the lipid panel you did in conjunction of the patients annual physical

which also wasn’t a covered service is that you did not code a diagnosis that

was not considered to be a screening diagnosis.  In the NCD the V- codes for

screening have a * by them which indicates these are only covered if done in

conjunction with the initial Welcome to Medicare Exam.

Routine screening and prophylactic testing for lipid disorder are

not covered by Medicare. While lipid screening may be medically appropriate,

Medicare by statute does not pay for it. Lipid testing in asymptomatic

individuals is considered to be screening regardless of the presence of other

risk factors such as family history, tobacco use, etc.

Once

a diagnosis is established, one or several specific tests are usually adequate

for monitoring the course of the disease. Less specific diagnoses (for example,

other chest pain) alone do not support medical necessity of these tests.

When

monitoring long-term anti-lipid dietary or pharmacologic therapy and when

following patients with borderline high total or LDL cholesterol levels, it is

reasonable to perform the lipid panel annually. A lipid panel at a yearly

interval will usually be adequate while measurement of the serum total

cholesterol or a measured LDL should suffice for interim visits if the patient

does not have hypertriglyceridemia.

Any

one component of the panel or a measured LDL may be medically necessary up to

six times the first year for monitoring dietary or pharmacologic therapy. More

frequent total cholesterol HDL cholesterol, LDL cholesterol and triglyceride

testing may be indicated for marked elevations or for changes to anti-lipid

therapy due to inadequate initial patient response to dietary or pharmacologic

therapy. The LDL cholesterol or total cholesterol may be measured three times

yearly after treatment goals have been achieved.

If

no dietary or pharmacological therapy is advised, monitoring is not necessary.

When

evaluating non-specific chronic abnormalities of the liver (for example,

elevations of transaminase, alkaline phosphatase, abnormal imaging studies,

etc.), a lipid panel would generally not be indicated more than twice per year.

Beth Sullivan, DO

Ridgeway Family Practice

Commerce, GA  30529

From:

[mailto: ] On Behalf Of Pierce

Sent: Tuesday, February 23, 2010 7:04 PM

To:

Subject: Re: Medicare billing inquiry today? Send

the money back!

Why can't you resubmit the claim with the correct code (V81.0)?

did complete preventive physcial on medicare

patient. She was paid $104. Patient requested cholesterol screening for

which medicare denied claim for V70.0. We billed patient $40. Patient

paid 144 total for physical and lipid panel.

Medicare called and inquired about the payment. Asked

us to return money because lipid panel was not indicated by the V70.0 code and

no ABN was signed?\

We will send the patient the $40. How do we avoid this

get ABN on everyone?

From: Alla

To:

Sent: Thu, February 18, 2010 8:31:29 AM

Subject: Re: freezy stuff

I bought the Brymill cryo unit et al at the

AAFP convention in Boston in October. I think I got a better deal on the

equipment because I bought it then. I may still have the business card for the

rep if anyone is interested.

Since October, I treated about 10 patients for actinic keratoses and skin tags.

I have not checked reimbursements.

Alla

Solo Family Practice

Travel Clinics of America

6559 Mills Road, Suite 107, Mayfield Village, OH 44143

| fax | www.travelclinicsof

america.com

> > >

> > >

> > >

> > >

> > >

> > >

> > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > they are giving away a box of speculums and a lighting source and

charger. I

> > just got mine in the mail. I can't figure out how they can afford to

give it

> > away unless they are really marking up the disposable speculums that

much

> > but thought I would pass it along in case anyone else may be

interested.

> > >

> > >

> > >

> > >

> > >

> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA-

KleenSpec- FreeOffer. html

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > Sangeetha Murthy M.D

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > ____________ _________ _________ _________ _________ _________ _

> > > Hotmail: Powerful Free email with security by Microsoft.

> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/

> > >

> >

> >

> >

>

[Guest guest]

Right now, , I use the LabCorp portal to order most of my

labs.  It automatically checks for whether the ICD-9’s justify the tests

ordered and if not, tells me and provides a list of covered ICD-9’s for me to

choose from if appropriate or an ABN to print.  It has been very helpful. 

Before that, it was hit or miss, I would have to call and find out.  I think

their used to be a web site that would link the two but I can’t seem to find it

anymore.  It would be from your local carrier though as they have some

flexibility with that.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Egly

Sent: Wednesday, February 24, 2010 7:52 AM

To:

Subject: Re: Medicare billing inquiry today? Send

the money back!

Thanks all,

I keep a coding file in email of all the suggestions from

over the years but I seem to have missed the one on screening for

cardiovascular disease. I really haven't had that many denied codes over

the years. Except this year the hospital where I do 99% of my testing is

calling almost every day requesting a different icd-9 for the tests I

run. Is there a website that you all use for what codes medicare pays for

at hospital and commercial labs.

No medicare did not pay for the physical. The patient paid

last fall for both physical and lipid panel. She initiated a billing

inquiry with medicare because medicare sent eob saying test was not medically

necessary. Our WPS contractor called yesterday stating to repay or she would

take it out of our billings to send to patient.

I will rebill medicare and refund patient.

Again thanks

From: Kathy Saradarian

To:

Sent: Tue, February 23, 2010 6:14:44 PM

Subject: RE: Medicare billing inquiry today? Send

the money back!

I’m not sure what V81.0 is but believe

it or not, screening for cardiovascular disease is covered by Medicare to

justify a lipid pane. I would search for those codes that will “coverâ€

what you order so patient is not responsible. If it is something patient

wants that you don’t think is indicated, get the ABN. By the way,

preventative physicals are not covered by Medicare. Don’t know how you

got paid for that.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypr actice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From: Practiceimprovement

1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On

Behalf Of Pierce

Sent: Tuesday, February 23, 2010 7:04 PM

To: Practiceimprovement 1yahoogroups (DOT) com

Subject: Re: [Practiceimprovemen t1] Medicare billing inquiry today?

Send the money back!

Why can't you resubmit the claim with the correct code (V81.0)?

did complete preventive physcial on medicare patient. She was paid $104.

Patient requested cholesterol screening for which medicare denied claim for

V70.0. We billed patient $40. Patient paid 144 total for physical and

lipid panel.

Medicare

called and inquired about the payment. Asked us to return money because

lipid panel was not indicated by the V70.0 code and no ABN was signed?\

We

will send the patient the $40. How do we avoid this get ABN on everyone?

From: Alla

<allakirschyahoo (DOT) com>

To: Practiceimprovement 1yahoogroups (DOT) com

Sent: Thu, February 18, 2010 8:31:29 AM

Subject: [Practiceimprovemen t1] Re: freezy stuff

I bought the Brymill cryo unit et al at the AAFP convention in Boston in

October. I think I got a better deal on the equipment because I bought it then.

I may still have the business card for the rep if anyone is interested.

Since October, I treated about 10 patients for actinic keratoses and skin tags.

I have not checked reimbursements.

Alla

Solo Family Practice

Travel Clinics of America

6559 Mills Road, Suite 107, Mayfield Village, OH 44143

| fax | www.travelclinicsof america.com

> > >

> > >

> > >

> > >

> > >

> > >

> > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > they are giving away a box of speculums and a lighting source and

charger. I

> > just got mine in the mail. I can't figure out how they can afford to

give it

> > away unless they are really marking up the disposable speculums that

much

> > but thought I would pass it along in case anyone else may be

interested.

> > >

> > >

> > >

> > >

> > >

> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA-

KleenSpec- FreeOffer. html

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > Sangeetha Murthy M.D

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > ____________ _________ _________ _________ _________ _________ _

> > > Hotmail: Powerful Free email with security by Microsoft.

> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/

> > >

> >

> >

> >

>

[Guest guest]

Medicare coverage determinations have seemed to have been changing a lot lately,

and I have been spending more time finding new ICD-9 codes for labs to get

things covered. Plenty of diagnoses that make sense are no longer working.

The most reliable place I have found for getting the latest updates is the

Medicare website. It's clunky and slow, but it's there. You can search both the

national (NCD) and local (LCD) determinations:

http://www.cms.hhs.gov/mcd/search.asp?clickon=search

Haresch

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > > This is not an ad. This is simply a link to the Welch Allyn website

where

> >> > they are giving away a box of speculums and a lighting source and

charger. I

> >> > just got mine in the mail. I can't figure out how they can afford to give

it

> >> > away unless they are really marking up the disposable speculums that much

> >> > but thought I would pass it along in case anyone else may be interested.

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA- KleenSpec-

FreeOffer. html

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > > --

> >> > > Sangeetha Murthy M.D

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > >

> >> > > ____________ _________ _________ _________ _________ _________ _

> >> > > Hotmail: Powerful Free email with security by Microsoft.

> >> > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/

> >> > >

> >> >

> >> >

> >> >

> >>

> > 

>

[Guest guest]

Medicare does cover screening lipid panel. Per the current NCD, dated 1/1/05: "

Effective January 1, 2005, the Medicare law expanded coverage to cardiovascular

screening services. Several of the procedures included in this NCD may be

covered for screening purposes subject to specified frequencies. See 42 CFR

410.17 and section 100, chapter 18, of the Claims Processing Manual, for a full

description of this benefit. "

And per the Medicare Guide to Preventive Services

http://cms.hhs.gov/MLNProducts/downloads/PSGUID.pdf:

" Effective with services performed on or after January 1, 2005, Medicare

provides coverage of cardiovascular screening blood tests for the early

detection of cardiovascular disease or abnormalities associated with an elevated

risk of heart disease and stroke. These tests will determine a beneficiary's

cholesterol and other blood lipid levels such as triglycerides. CMS recommends

that all eligible beneficiaries take advantage of this coverage, which can

determine whether beneficiaries are at high risk for cardiovascular disease. "

" The cardiovascular screening blood tests covered by Medicare are: Total

Cholesterol Test Cholesterol Test for High-Density Lipoproteins

Triglycerides Test "

" Medicare provides coverage of cardiovascular screening blood tests for all

asymptomatic beneficiaries every 5 years (i.e., at least 59 months after the

last covered screening tests). The screening blood tests must be ordered by the

physician or qualified non physician practitioner treating the beneficiary for

the purpose of early detection of cardiovascular disease. The beneficiary must

have no apparent signs or symptoms of cardiovascular disease. "

" Coverage of cardiovascular screening blood tests is provided as a Medicare Part

B benefit. The beneficiary will pay nothing for the blood test (there is no

coinsurance or copayment and no deductible for this benefit). "

" One or more of the following ICD-9-CM ( " V " ) diagnosis code(s) must be reported

for cardiovascular screening blood tests:

V81.0 Special screening for ischemic heart disease

V81.1 Special screening for hypertension

V81.2 Special screening for other and unspecified cardiovascular conditions "

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > This is not an ad. This is simply a link to the Welch Allyn website

where

> > > they are giving away a box of speculums and a lighting source and charger.

I

> > > just got mine in the mail. I can't figure out how they can afford to give

it

> > > away unless they are really marking up the disposable speculums that much

> > > but thought I would pass it along in case anyone else may be interested.

> > > >

> > > >

> > > >

> > > >

> > > >

> > > http://www.welchall yn.com/campaigns /q42008_bright_ light/WA-

<http://www.welchallyn.com/campaigns/q42008_bright_light/WA-KleenSpec-FreeOffer.\

html> KleenSpec- FreeOffer. html

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > Sangeetha Murthy M.D

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ _________ _________ _________ _

> > > > Hotmail: Powerful Free email with security by Microsoft.

> > > > http://clk.atdmt. com/GBL/go/ 201469230/ direct/01/

<http://clk.atdmt.com/GBL/go/201469230/direct/01/>

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

I went to the same site  and got the info I pasted from the

current lab manual billing NCD.  That was the point I was making in that they

have 2 documents that are supposedly both current that contradict one another.

Beth Sullivan, DO

Ridgeway Family Practice

Commerce, GA  30529

From:

[mailto: ] On Behalf Of newfloc

Sent: Wednesday, February 24, 2010 11:02 AM

To:

Subject: Re: Medicare billing inquiry today? Send

the money back!

Medicare does cover screening lipid panel. Per

the current NCD, dated 1/1/05: " Effective January 1, 2005, the Medicare

law expanded coverage to cardiovascular screening services. Several of the

procedures included in this NCD may be covered for screening purposes subject

to specified frequencies. See 42 CFR 410.17 and section 100, chapter 18, of the

Claims Processing Manual, for a full description of this benefit. "

And per the Medicare Guide to Preventive Services http://cms.hhs.gov/MLNProducts/downloads/PSGUID.pdf:

" Effective with services performed on or after January 1, 2005, Medicare

provides coverage of cardiovascular screening blood tests for the early

detection of cardiovascular disease or abnormalities associated with an

elevated risk of heart disease and stroke. These tests will determine a

beneficiary's cholesterol and other blood lipid levels such as triglycerides.

CMS recommends that all eligible beneficiaries take advantage of this coverage,

which can determine whether beneficiaries are at high risk for cardiovascular

disease. "

" The cardiovascular screening blood tests covered by Medicare are: Total

Cholesterol Test Cholesterol Test for High-Density Lipoproteins Triglycerides

Test "

" Medicare provides coverage of cardiovascular screening blood tests for all

asymptomatic beneficiaries every 5 years (i.e., at least 59 months after the

last covered screening tests). The screening blood tests must be ordered by the

physician or qualified non physician practitioner treating the beneficiary for

the purpose of early detection of cardiovascular disease. The beneficiary must

have no apparent signs or symptoms of cardiovascular disease. "

" Coverage of cardiovascular screening blood tests is provided as a

Medicare Part B benefit. The beneficiary will pay nothing for the blood test

(there is no coinsurance or copayment and no deductible for this

benefit). "

" One or more of the following ICD-9-CM ( " V " ) diagnosis code(s)

must be reported for cardiovascular screening blood tests:

V81.0 Special screening for ischemic heart disease

V81.1 Special screening for hypertension

V81.2 Special screening for other and unspecified cardiovascular

conditions "

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > > they are giving away a box of speculums and a lighting source

and charger. I

> > > just got mine in the mail. I can't figure out how they can

afford to give it

> > > away unless they are really marking up the disposable speculums

that much

> > > but thought I would pass it along in case anyone else may be

interested.

> > > >

> > > >

> > > >

> > > >

> > > >

> > > http://www.welchall

yn.com/campaigns /q42008_bright_ light/WA- <http://www.welchallyn.com/campaigns/q42008_bright_light/WA-KleenSpec-FreeOffer.html>

KleenSpec- FreeOffer. html

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > Sangeetha Murthy M.D

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ _________ _________

_________ _

> > > > Hotmail: Powerful Free email with security by Microsoft.

> > > > http://clk.atdmt.

com/GBL/go/ 201469230/ direct/01/ <http://clk.atdmt.com/GBL/go/201469230/direct/01/>

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

In a most timely fashion, one of our local

labs just dropped of the 2009-2010 NCD by lab type and what the approved ICD-9’s

are for those labs J  I only wish that they would just make it easier by putting it on

a website instead of wasting a bunch of paper…

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of Beth Sullivan, DO

Sent: Wednesday, February 24, 2010

12:43 PM

To:

Subject: RE:

Re: Medicare billing inquiry today? Send the money back!

I went to the same site and got the info I pasted from the

current lab manual billing NCD. That was the point I was making in that

they have 2 documents that are supposedly both current that contradict one

another.

Beth Sullivan, DO

Ridgeway Family

Practice

Commerce, GA

30529

From:

[mailto: ] On Behalf Of newfloc

Sent: Wednesday, February 24, 2010

11:02 AM

To:

Subject:

Re: Medicare billing inquiry today? Send the money back!

Medicare

does cover screening lipid panel. Per the current NCD, dated 1/1/05: "

Effective January 1, 2005, the Medicare law expanded coverage to cardiovascular

screening services. Several of the procedures included in this NCD may be

covered for screening purposes subject to specified frequencies. See 42 CFR

410.17 and section 100, chapter 18, of the Claims Processing Manual, for a full

description of this benefit. "

And per the Medicare Guide to Preventive Services http://cms.hhs.gov/MLNProducts/downloads/PSGUID.pdf:

" Effective with services performed on or after January 1, 2005, Medicare

provides coverage of cardiovascular screening blood tests for the early

detection of cardiovascular disease or abnormalities associated with an

elevated risk of heart disease and stroke. These tests will determine a

beneficiary's cholesterol and other blood lipid levels such as

triglycerides. CMS recommends that all eligible beneficiaries take advantage of

this coverage, which can determine whether beneficiaries are at high risk for

cardiovascular disease. "

" The cardiovascular screening blood tests covered by Medicare are: Total

Cholesterol Test Cholesterol Test for High-Density Lipoproteins Triglycerides

Test "

" Medicare provides coverage of cardiovascular screening blood tests for

all asymptomatic beneficiaries every 5 years (i.e., at least 59 months after

the last covered screening tests). The screening blood tests must be ordered by

the physician or qualified non physician practitioner treating the beneficiary

for the purpose of early detection of cardiovascular disease. The beneficiary

must have no apparent signs or symptoms of cardiovascular disease. "

" Coverage of cardiovascular screening blood tests is provided as a

Medicare Part B benefit. The beneficiary will pay nothing for the blood test

(there is no coinsurance or copayment and no deductible for this

benefit). "

" One or more of the following ICD-9-CM ( " V " ) diagnosis code(s)

must be reported for cardiovascular screening blood tests:

V81.0 Special screening for ischemic heart disease

V81.1 Special screening for hypertension

V81.2 Special screening for other and unspecified cardiovascular

conditions "

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > > they are giving away a box of speculums and a lighting source

and charger. I

> > > just got mine in the mail. I can't figure out how they can

afford to give it

> > > away unless they are really marking up the disposable speculums

that much

> > > but thought I would pass it along in case anyone else may be

interested.

> > > >

> > > >

> > > >

> > > >

> > > >

> > > http://www.welchall

yn.com/campaigns /q42008_bright_ light/WA- <http://www.welchallyn.com/campaigns/q42008_bright_light/WA-KleenSpec-FreeOffer.html>

KleenSpec- FreeOffer. html

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > Sangeetha Murthy M.D

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ _________ _________

_________ _

> > > > Hotmail: Powerful Free email with security by Microsoft.

> > > > http://clk.atdmt.

com/GBL/go/ 201469230/ direct/01/ <http://clk.atdmt.com/GBL/go/201469230/direct/01/>

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

Sorry, it’s spiral-bound and about 200

pages.  It is 2/3 the thickness of my CPT book.  Here is the link to the most

recent (8/09) NCD for labs:

http://www.cms.hhs.gov/coveragegeninfo/downloads/manual200907.pdf

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Carla Gibson

Sent: Wednesday, February 24, 2010

10:36 PM

To:

Subject: Re:

Re: Medicare billing inquiry today? Send the money back!

:

Could you scan and share with the group? Seemed like many here

would find that helpful.

Carla

From: Pratt

<karen.oaktreecomcast (DOT) net>

To:

Sent: Wed, February 24, 2010

2:02:43 PM

Subject: RE:

Re: Medicare billing inquiry today? Send the money back!

In a most timely fashion, one of our local labs just dropped of the

2009-2010 NCD by lab type and what the approved ICD-9’s are for those labs J I only wish that

they would just make it easier by putting it on a website instead of wasting a

bunch of paper…

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd. info

From: Practiceimprovement 1yahoogroups (DOT) com

[mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of Beth Sullivan, DO

Sent: Wednesday, February 24, 2010

12:43 PM

To: Practiceimprovement

1yahoogroups (DOT) com

Subject: RE: [Practiceimprovemen

t1] Re: Medicare billing inquiry today? Send the money back!

I went to the same site and got the info I pasted from the

current lab manual billing NCD. That was the point I was making in that

they have 2 documents that are supposedly both current that contradict one

another.

Beth Sullivan, DO

Ridgeway Family

Practice

Commerce, GA

30529

From: Practiceimprovement 1yahoogroups (DOT) com

[mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of newfloc

Sent: Wednesday, February 24, 2010

11:02 AM

To: Practiceimprovement

1yahoogroups (DOT) com

Subject: [Practiceimprovemen t1]

Re: Medicare billing inquiry today? Send the money back!

Medicare

does cover screening lipid panel. Per the current NCD, dated 1/1/05: "

Effective January 1, 2005, the Medicare law expanded coverage to cardiovascular

screening services. Several of the procedures included in this NCD may be

covered for screening purposes subject to specified frequencies. See 42 CFR

410.17 and section 100, chapter 18, of the Claims Processing Manual, for a full

description of this benefit. "

And per the Medicare Guide to Preventive Services http://cms.hhs.

gov/MLNProducts/ downloads/ PSGUID.pdf:

" Effective with services performed on or after January 1, 2005, Medicare

provides coverage of cardiovascular screening blood tests for the early

detection of cardiovascular disease or abnormalities associated with an

elevated risk of heart disease and stroke. These tests will determine a

beneficiary' s cholesterol and other blood lipid levels such as triglycerides.

CMS recommends that all eligible beneficiaries take advantage of this coverage,

which can determine whether beneficiaries are at high risk for cardiovascular

disease. "

" The cardiovascular screening blood tests covered by Medicare are: Total

Cholesterol Test Cholesterol Test for High-Density Lipoproteins Triglycerides

Test "

" Medicare provides coverage of cardiovascular screening blood tests for

all asymptomatic beneficiaries every 5 years (i.e., at least 59 months after

the last covered screening tests). The screening blood tests must be ordered by

the physician or qualified non physician practitioner treating the beneficiary

for the purpose of early detection of cardiovascular disease. The beneficiary

must have no apparent signs or symptoms of cardiovascular disease. "

" Coverage of cardiovascular screening blood tests is provided as a

Medicare Part B benefit. The beneficiary will pay nothing for the blood test

(there is no coinsurance or copayment and no deductible for this

benefit). "

" One or more of the following ICD-9-CM ( " V " ) diagnosis code(s)

must be reported for cardiovascular screening blood tests:

V81.0 Special screening for ischemic heart disease

V81.1 Special screening for hypertension

V81.2 Special screening for other and unspecified cardiovascular

conditions "

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > This is not an ad. This is simply a link to the Welch Allyn

website where

> > > they are giving away a box of speculums and a lighting source

and charger. I

> > > just got mine in the mail. I can't figure out how they can

afford to give it

> > > away unless they are really marking up the disposable speculums

that much

> > > but thought I would pass it along in case anyone else may be

interested.

> > > >

> > > >

> > > >

> > > >

> > > >

> > > http://www.welchall

yn.com/campaigns

/q42008_bright_ light/WA- <http://www.welchall yn.com/campaigns /q42008_bright_ light/WA-

KleenSpec- FreeOffer. html> KleenSpec- FreeOffer. html

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > Sangeetha Murthy M.D

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ____________ _________ _________ _________ _________

_________ _

> > > > Hotmail: Powerful Free email with security by Microsoft.

> > > > http://clk.atdmt.

com/GBL/go/ 201469230/ direct/01/ http://clk.atdmt.

com/GBL/go/ 201469230/ direct/01/>

> > > >

> > >

> > >

> > >

> >

>