Cardiology Question for the Week of April 16, 2018

Cardiology Compliance Question of the Week

Question:

What codes should be assigned for the ECG provided during Medicare’s initial preventive physical examination (IPPE)?

Answer:

The IPPE includes the performance and interpretation of a screening electrocardiogram (ECG) for new Medicare beneficiaries, effective January 1, 2005. Depending on the outcome of the ECG and the other services, patient education and counseling, as well as a referral, also may be included.

The following codes may be assigned to file claims for the IPPE and screening ECG:

G0402 IPPE; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
G0403 Electrocardiograms, routine ECG with 12 leads; performed as a screening for the IPPE with interpretation and report
G0404 tracing only, without interpretation and report, performed as a screening for the IPPE
G0405 interpretation and report only, performed as a screening for the IPPE

For more on the IPPE, go to https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QRI_IPPE001a.pdf.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.