This is a new benefit beginning for dates of service on and after 12/08/09
CPT code G0432 – Infectious agent antibody detection by enzyme immunoassay (EIA) technique, HIV-1 and/or HIV-2, screening
CPT code G0433 – Infectious agent antibody detection by enzyme-linked immunosorbent assay (ELISA) technique, HIV-1 and/or HIV-2, screening
G0435 – Infectious agent antibody detection by rapid antibody test, HIV-1 and/or HIV-2, screening
Report one of the following codes:
V73.89 – Primary
V22.0, V22.1, V69.8, or V23.9 – Secondary, as appropriate
Beneficiaries who are at increased risk for HIV infection or pregnant**
** Increased risk for HIV infection is defined in the “National Coverage Determinations (NCD) Manual,” Publication 100-03, Sections 190.14 (diagnostic) and 210.7 (screening). See http://www.cms.gov/ manuals/downloads/ncd103c1_Part3.pdf and http://www.cms.gov/manuals/ downloads/ncd103c1_Part4.pdf on the Internet.
Annually for beneficiaries at increased risk Three times per pregnancy for beneficiaries who are pregnant:
a. When woman is diagnosed with pregnancy;
b. During the 3rd trimester; and c. At labor, if ordered by the woman’s clinician.
• Copayment/coinsurance waived
• Deductible waived