LIPID PANEL CHOLESTEROL LIPOPROTEIN, ELECTROPHORETIC SEPARATION LIPOPROTEIN, DIRECT MEASUREMENT (HDL) LDL DIRECT TRIGLYCERIDES



Similar documents
NCD for Lipids Testing

LCD L Lipid Profile/Cholesterol Testing Print

CHAPTER 9 DISEASES OF THE CIRCULATORY SYSTEM (I00-I99)

ICD-9-CM/ICD-10-CM Codes for MNT

Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology

Diagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses

ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES AND IMMUNITY DISORDERS

LCD for Viral Hepatitis Serology Tests

Adult Cardiac Surgery ICD9 to ICD10 Crosswalks

Cardiovascular diseases. pathology

Primary Care Management of Women with Hyperlipidemia. Julie Marfell, DNP, BC, FNP, Chairperson, Department of Family Nursing

Stroke Coding Issues Presentation to: NorthEast Cerebrovascular Consortium

Malmö Preventive Project. Cardiovascular Endpoints

Local Coverage Article: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non- Oncologic Conditions (A53134)

Your healthcare provider has ordered a Boston Heart Cardiac Risk Assessment

LCD L C-Reactive Protein High Sensitivity Testing (hscrp)

INTRODUCTION TO EECP THERAPY

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD

APPENDIX A NEUROLOGIST S GUIDE TO USING ICD-9-CM CODES FOR CEREBROVASCULAR DISEASES INTRODUCTION

Malmö Preventive Project. Cardiovascular Endpoints

Ischemia and Infarction

ICD-10 for Cardiology

Guidelines Most Significantly Affected Under ICD-10-CM. May 29, 2013

Role of Body Weight Reduction in Obesity-Associated Co-Morbidities

Disability Evaluation Under Social Security

Guidelines for the management of hypertension in patients with diabetes mellitus

Cardiovascular Endpoints

High Blood Cholesterol

Lipid Testing CPT Code : Frequency Limitation Medicare National Coverage Determination Policy

Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes

LIMITED BENEFIT HEALTH COVERAGE FOR SPECIFIED CRITICAL ILLNESS. OUTLINE OF COVERAGE (Applicable to Policy Form CI-1.0-NC)

Cardiovascular Risk in Diabetes

Education. Panel. Triglycerides & HDL-C

Alpha-fetoprotein

Cardiovascular Endpoints

DIABETES YOUR GUIDE TO

PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015

Risk Adjustment Factor (RAF) RADV June 1 st 2016

Breaking the Code: ICD-9-CM Coding in Details

HYPERTENSION ASSOCIATED WITH RENAL DISEASES

Osama Jarkas. in Chest Pain Patients. STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015

Acquired Heart Disease: Prevention and Treatment

Preparing for ICD-10 for Physicians

MEDICAL POLICY No R1 DRUG-ELUTING STENTS FOR ISCHEMIC HEART DISEASE

Cardiovascular Disease Risk Factors

Central Office N/A N/A

How To Treat Dyslipidemia

DIAGNOSTIC CRITERIA OF STROKE

Preoperative Laboratory and Diagnostic Studies

ICD-10 Transition & Implementation Information

Vertebrobasilar Disease

PRESCRIBING GUIDELINES FOR LIPID LOWERING TREATMENTS for SECONDARY PREVENTION

MY TYPE 2 DIABETES NUMBERS

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations.

Diagnostic and Therapeutic Procedures

Critical Illness Insurance

ROLE OF LDL CHOLESTEROL, HDL CHOLESTEROL AND TRIGLYCERIDES IN THE PREVENTION OF CORONARY HEART DISEASE AND STROKE

Diabetes Mellitus and the Circulatory System

CMS Limitations Guide - Laboratory Services

How To Understand What You Know

ICD-10 CM Training. Family Practice

Home Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes

Diabetes and Heart Disease

EXECUTIVE BLOOD WORK PANEL

Cardiac Rehabilitation (Outpatient Phase II) Corporate Medical Policy. Medical Policy

Measure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care

DIAGNOSIS CODING TIPS INDEX

Medtronic Cardiac Rhythm and Heart Failure ICD-10 Coding for Physicians

PHARMACOLOGICAL Stroke Prevention in Atrial Fibrillation STROKE RISK ASSESSMENT SCORES Vs. BLEEDING RISK ASSESSMENT SCORES.

Clinical Quality Measure Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW

KIH Cardiac Rehabilitation Program

CARDIA 288 MONTH FOLLOW-UP SUPPLEMENTAL FORM (FORM B) HOSPITALIZATION CASE #: INTERVIEWER ID FY288BIVID2. Page 1 of 6 FY288BH4CN

Understanding Mortality Statistics: The Importance of Cause-of-Death Certification and Coding

HCIM ICD-10 Training Online Course Catalog August 2015

Hospital-based SNF Coding Tip Sheet: Top 25 codes and ICD-10 Chapter Overview

Cilostazol versus Clopidogrel after Coronary Stenting

Major Diagnosis Coding ICD-9-CM and ICD-10-CM. Overview

Psoriasis Co-morbidities: Changing Clinical Practice. Theresa Schroeder Devere, MD Assistant Professor, OHSU Dermatology. Psoriatic Arthritis

Corporate Medical Policy

CHLAMYDIA SCREENING IN WOMEN

Employee Critical Illness Option

Protocol. Cardiac Rehabilitation in the Outpatient Setting

Long term care coding issues for ICD-10-CM

Let s talk about: Stroke

Listen to your heart: Good Cardiovascular Health for Life

Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS

EXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA. a) pharmacy records reflecting the dispensing of Bextra and/or Celebrex to the Class Member; or

American Fidelity Assurance Company s. AF Critical Choice. Limited Benefit Critical Illness Insurance. Financial Protection is a Choice

Documentation Strategies in an ICD-10 World

BCCA Protocol Summary for Palliative Treatment of Advanced Pancreatic Neuroendocrine Tumours using SUNItinib (SUTENT )

MISSING DATA ANALYSIS AMONG PATIENTS IN THE PINNACLE REGISTRY

Fewer people with coronary heart disease are being diagnosed as compared to the expected figures.

COMMITTEE FOR HUMAN MEDICINAL PRODUCTS (CHMP) DRAFT GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR DISEASE PREVENTION

Transcription:

Test Code Test Name CPT CHOL Cholesterol, Serum 82465 HDL HDL, (High Density Lipoprotein) 83718 TRIG Triglycerides, Serum 84478 FTRIG Triglycerides (Fluid) 84478 LIPID Lipid Panel 80061 LDL LDL (Low Density Lipoprotein) Direct Measurement 83721 LIPE Lipoprotein Electrophoresis 83700 **** Lipoprotein High Resolution Fractionation 83701 And Quantitation **** Quantitation of Lipoprotein particle 83704 numbers and lipoprotein particles subclasses MEDICARE LIMITATIONS AND GUIDELINES: 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 (CPT code 80061) at a yearly interval will usually be adequate while measurement of the serum total cholesterol (CPT code 82465) or a measured LDL (CPT code 83721) should suffice for interim visits if the patient does not have hypertriglyceridemia (for example, ICD-9-CM code 272.1, Pure hyperglyceridemia). 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 HDLcholesterol, 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 phosphates, abnormal imaging studies, etc.), a lipid panel would generally not be indicated more than twice per year.

Narrative Description ICD9 Light for dates with signs of fetal malnutrition 764.10 764.19 Abnormal alkaline phosphatase 790.5 Abnormal imaging study 793.4 Abnormal transaminase 790.4 Acute myocardial infarction 410.00 410.92 Acute renal failure with lesion of tubular necrosis 584.5 Alcoholism 303.90 303.92 Amyloidosis 277.30 Aneurysm, heart (wall) 414.10 Angina pectoris 413.0 413.1 Aortic aneurysms 441.00 441.9 Arterial embolism & thrombosis 444.0 444.9 Arteriosclerosis 440.0 440.9 Arteriosclerotic cardiovascular disease 429.2 Benign essential hypertension (Any form of atherosclerotic disease, or any disease 401.1 leading to the formation of atherosclerotic disease) Biliary atresia 751.61 Chest pain, other 786.59 Chest pain, unspecified 786.50 Chronic ischemic heart disease, unspecified 414.9 Chronic kidney disease, Stage IV (severe) 585.4 Chronic kidney disease, Stage V 585.5 Chronic kidney disease, unspecified 585.9 Chronic vascular insufficiency of intestine 557.1 Complication of transplanted organ, kidney 996.81 Corneal arcus, juvenile 371.41 Coronary atherosclerosis of coronary artery of transplanted heart 414.00 414.06

Coronary atherosclerosis, of bypass graft (artery)(vein) of transplanted heart 414.07 Coronary athrsci-artery bypass graft 414.04 Coronary athrsci-unspec graft 414.05 Coronary occlusion without myocardial infarction 411.81 Coronary vessel aneurysm 414.11-414.12 Crystalline deposits in vitreous 379.22 Cushing s syndrome 255.0 Degenerative and vascular disorder of ear, unspecified 388.00 Diabetes mellitus 250.00 250.93 Disorders of the thyroid gland with hormonal dysfunction 242.00 245.9 Disturbances of amino-acid transport 270.0 End stage renal disease 585.6 Essential hypertension 401.0, 401.9 Familial Mediterranean fever 277.31 Galactosemia 271.1 Heart disease NOS 429.9 Heart failure 428.0 428.9 Heart Failure (Combined systolic and diastolic) 428.40 428.43 Heart Failure (Diastolic) 428.30 428.33 Heart Failure (Systolic) 428.20 428.23 Hepatomegaly 789.1 Hyperchylomicronemia 272.1 Hyperchylomicronemia 272.3 Hypertensive heart and chronic kidney disease 404.00 404.93 Hypertensive heart disease 402.00 402.91 Hypertensive chronic kidneyl disease 403.00 403.91 Iliac artery aneurysm 442.2 Impotence of organic origin, penis disorder 607.84

Intracerebral hemorrhage 431 Kwashiorkor 260 Late effects of cerebrovascular disease (438.0 438.9), 438.6, 438.7, 438.83, 438.84, 438.85 Lipidoses 272.7 Lipodystrophy 272.6 Lipoprotein deficiencies 272.5 Liver disorder antepartum 646.73 Liver disorders in pregnancy 646.70 646.71 Long Term (current) use of antiplatelet/antithrombotic V58.63 Long Term (current) use of non-steroidal anti-inflammatories V58.64 Long term (current) use of other medications V58.69 Malnutrition of mild degree 263.1 Malnutrition of moderate degree 263.0 Mixed hyperlipidemia (tuberous xanthoma) 272.2 Morbid obesity 278.01 Moyamoya disease 437.5 Nephrogenic diabetes insipidus 588.1 Nephrotic syndrome 581.0 581.9 Nutritional marasmus 261 Obesity 278.00 Occlusion & stenosis of precerebral arteries 433.00 433.91 Occlusion of cerebral arteries 434.00 434.91 Old myocardial infarction 412 Organ replacement by transplant, liver V42.7 Other & unspecified postsurgical nonabsorption 579.3 Other abnormal blood chemistry 790.6 Other acute and subacute ischemic heart disease 411.0 411.1

Other acute and subacute ischemic heart disease 411.89 Other amyloidosis 277.39 Other and ill-defined cerebrovascular disease 437.0 Other and unspecified angina pectoris 413.9 Other and unspecified hyperlipidemia (unspecified xanthoma) 272.4 Other aneurysm of heart 414.19 Other background retinopathy and retinal vascular change 362.10 362.16 Other chronic liver disease without mention of alcohol 571.8 Other disorders of lipoid metabolism 272.8 Other generalized ischemic cerebrovascular disease 437.1 Other protein-calorie malnutrition 263.8 Other psoriasis 696.1 Other severe, protein-calorie malnutrition 262 Other specified disorders of liver 573.8 Other specified disorders resulting from impaired renal function 588.89 Other specified forms of chronic ischemic heart disease 414.8 Other specified intestinal malabsorption 579.8 Overweight 278.02 Pancreatic disease 577.0 577.9 Precordial pain 786.51 Psoriatic arthropathy 696.0 Pure hypercholesterolemia 272.0 Renal artery aneurysm 442.1 Renal osteodystrophy 588.0 Retinal exudates and deposits 362.82 Retinal vascular occlusion 362.30 362.34 Secondary hyperparathyroidism (of renal origin) 588.81 Secondary hypertension 405.01 405.99

Special screening for cardiovascular diseases V81.0 V81.2 Thyroid disfunction in pregnancy and the puerperium 648.10 648.14 Toxic effect of unspecified gas or vapor 987.9 Transient cerebral ischemia 435.0 435.9 Transient ischemic deafness 388.02 Transplanted organ, kidney V42.0 Unspecified chronic liver disease without mention of alcohol 571.9 Unspecified disorder resulting from impaired renal function 588.9 Unspecified disorders of lipoid metabolism 272.9 Unspecified disorders of liver 573.9 Unspecified protein-calorie malnutrition 263.9 Upper extremity aneurysm 442.0 Xanthelasma 374.51

LIPOPROTEIN ELECTROPHORETIC SEPARATION ICD Codes Numerical Order 242.00 245.9 250.0 250.93 255.0 260 263.9 270.0 271.1 272.0 272.9 277.30-277.31 277.39 278.00-278.02 303.90 303.92 362.10 362.16 362.30 362.34 362.82 371.41 374.51 379.22 388.00 388.02 401.0 401.1 401.9 402.00-402.91 403.00-403.91 404.00-404.93 405.01-405.99 410.00 414.9 414.07 428.0 428.9 428.20-428.23 428.30-428.33 428.40-428.43 429.2 429.9 431 433.00 433.91 434.00-434.91 435.0-435.9 437.0 437.1 437.5 438.0 438.9 438.6 438.7 438.83 438.84 438.85 440.0 440.9 441.00 441.9 442.0 442.1 442.2 444.0 444.9 557.1 571.8 571.9 573.8 573.9 577.0 577.9 579.3 579.8 581.0 581.9 584.5 585.4 585.9 588.0 588.1 588.81 588.89 588.9 607.84 646.70 646.73 648.10 648.14 696.0 696.1 751.61 764.10-764.19 786.50 786.51 786.59 789.1 790.4 790.5 790.6 793.4 987.9 996.81 V42.0 V42.7 V58.63 V58.64 V58.69 V81.0 V81.1 V81.2