Wednesday, February 24, 2016

CPT CODE 80061, 82465 , 84478 AND G0472 - ICD 10 Z72.89, F19.20 AND Z13.6

Cardiovascular Disease Screening Tests

HCPCS/CPT Codes

80061 – Lipid panel, this panel must include the following:
82465 – Cholesterol, serum, total
83718 – Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol)
84478 – Triglycerides

ICD-10-CM Codes
Z13.6

Who Is Covered
All Medicare beneficiaries without apparent signs or symptoms of cardiovascular disease

Frequency
Once every 5 years

Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived

New Service! Medicare began covering HCV screening effective June 2, 2014.

HCPCS/CPT Codes

G0472 – Hepatitis C antibody screening, for individual at high risk and other covered indication(s)

ICD-10-CM Codes
Z72.89 and F19.20

Who Is Covered

Certain adult Medicare beneficiaries who:
• Are at high risk for HCV infection; or
• Were born between 1945 and 1965

Frequency
• Annually only for high risk beneficiaries with continued illicit injection drug use since the prior negative screening test; or
• Once in a lifetime for beneficiaries born between 1945 and 1965 who are not considered high risk.


Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived

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