2 thoughts on “Welcome to Medicare | Commentary by Cate Kortzeborn”

  1. I’m a 68 year old with perfect health. During a recent Medicare wellness visit, my doctor gave me two lab slips: one for a standard lipid blood panel and the other for a 14-part comprehensive metabolic panel (CMP-14).

    When I got to the lab I was told that because the ICD-10 diagnostic codes on the slips was Z00.00, which is defined as “encounter for general adult medical examination without abnormal findings,” I would have to pay the entire cost out of my own pocket. Apparently Medicare only covers lab tests for patients already known to be sick.

    I called Medicare and confirmed that routine tests to screen for conditions not yet bad enough to present with symptoms are not covered. What I’d like to know is why Medicare encourages beneficiaries to have an annual wellness visit with their GP when it then refuses to pay for the associated blood work. Don’t such tests exist to detect metabolic issues before they emerge with major symptoms?

  2. You are correct. Per CMS guidelines lab test will not be paid for a healthy person. The labs will be paid for preexisting condition which have a diagnosis.

    These lab test itself detects metabolic issues before the major symptoms appear like blood sugar, cholestrol etc.

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