When to use a screeing diagnosis for Labs

Provider ordered routine lab for an upcoming PX to check on pts previously diagnosed conditions of Hyperthyroidism and Hyperlipidemia. Patient claimed service was denied by insurance. They claim it was denied because V70.0 was not used in place of 244.9 and 272.4. Doesn't the medical diagnosis of a known condition over-ride the screening diagnosis?

Thanks for any help.

re: When to use a screeing diagnosis for Labs

I'll defer to the experts but I will code these as the patient requests. If the insurer tells them they have $xx coverage for wellness and to have the doctor code all labs with V70.0, then I do it. Likewise, if they have little coverage for wellness, I code the exam with V70.0 and the labs with the appropriate diagnosis code.

But at the same time you should not code a visit fraudulently; for example, if the visit is a BP followup and the patient asks you to bill it V70.0, say no.

re: When to use a screeing diagnosis for Labs

With the passage of health care reform, more patients are going to have first dollar coverage for preventive services. The problem is, two patients with the same insurance can still have wildly different policies and coverage, and we don't know when we send out the test.