CPT code 80061, 82465, 83718 & 84478

Cardiovascular Screening Blood Tests

Every year, thousands of Americans die of heart disease and stroke. Millions more currently live with one or more types of cardiovascular disease, including, coronary heart disease, stroke, high blood pressure, congestive heart failure, congenital cardiovascular defects, and hardening of the arteries. Heart disease and stroke are also among the leading causes of disability for both men and women in the United States.

Recognizing the need for early detection to effectively combat the risks of cardiovascular disease, Congress expanded preventive services to include the coverage of cardiovascular screening blood tests. Section 612 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 established Medicare coverage of cardiovascular screening blood tests.

The cardiovascular screening blood tests covered by Medicare include the following:

Total Cholesterol Test
Cholesterol Test for High Density Lipoproteins
Triglycerides Test

NOTE: The beneficiary must fast for 12 hours prior to testing. Other cardiovascular screening blood tests remain non-covered .

CPT Codes for Cardiovascular Screening Blood Tests
80061 – Lipid Panel This panel must include the following:Cholesterol, serum, total (82465)Lipoprotein, direct measurement, high density cholesterol (HDLcholesterol) (83718)Triglycerides (84478)

82465 – Cholesterol, serum or whole blood, total (For high density lipoprotein HDL,use 83718)

83718 – Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)

84478 – Triglycerides

Diagnosis covered
Medicare providers must report one or more of the following International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) screening (“V”) diagnosis code(s) 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

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