ippe visit cpt code

Initial Preventive Physical Examination

What is the initial preventive physical examination (ippe).

The Initial Preventive Physical Examination (IPPE) is also known as the “Welcome to Medicare Preventive Visit.” The IPPE is a preventive visit offered to newly-enrolled Medicare beneficiaries. Despite its name, the IPPE does not include an extensive physical examination. Rather, this service focuses on health promotion and disease prevention and detection. The IPPE is an opportunity for physicians to improve the quality of care, assist in patient engagement, and optimize payment opportunities.

IPPE Coding

The four HCPCS codes used to report IPPE services and ECG screenings are:

• G0402 – IPPE is a face to face visit. Service is limited to a new beneficiary during the first 12 months of Medicare enrollment.
• G0403 – Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report)
• G0404 – ECG performed as a screening for the IPPE (tracing only without interpretation and report)
• G0405 – ECG performed as a screening for the IPPE (interpretation and report only)  

Requirements and Components for IPPE

Requirements and components for G0402 include:

• Patients are only eligible if they are in their first 12 months of Medicare Part B coverage.
• Medicare pays for one IPPE per beneficiary, per lifetime.
• Past medical/surgical history
• Current medications and supplements
• Family history
• Physical activity
• History of alcohol, tobacco, and illicit drug use
• If the patient uses opioids, assess the benefit of other non-opioid pain therapies.
• Review the beneficiary’s potential risk factors for depression and other mood disorders
• Hearing impairment
• Activities of daily living
• Home safety
• Height, weight, body mass index, and blood pressure
• Visual acuity screen
• Other factors deemed appropriate based on the beneficiary’s history
• End-of-life planning, on agreement of the beneficiary
• Educate, counsel, and refer based on results of the review and evaluation services of previous components
• A once-in-a-lifetime screening ECG, as appropriate
• Appropriate screenings and other Medicare-covered preventive services

Health Care Professionals Who May Furnish and Bill IPPE:

• Physician assistant (PA)
• Nurse Practitioner (NP)
• Certified Clinical Nurse Specialist (CNS)

Non-physicians must be legally authorized and qualified to provide the IPPE in the state in which the services are furnished.

AAFP’s Position on IPPEs

The AAFP supports this preventive coverage as it provides an opportunity to deliver, document, and bill for the service. Implementing the service allows physicians to invest in patient-centered, team-based care while promoting quality and cost-effective care.

What You Need to Know

It is important to remember that Medicare beneficiaries are only eligible for the IPPE if they are in their first 12 months of Medicare Part B coverage. After the first 12 months of coverage, beneficiaries are eligible for the  Annual Wellness Visit. This benefit is covered 100% for the beneficiary.

Approaches to Help Your Practice Get Started

• Use this service to identify patients who would benefit from a discussion regarding their self-management health goals.
• Choose patients which the staff has identified as likely within the first 12 months of Medicare coverage. Use this service to risk stratify your patient population.
• Use this service to document diagnoses and conditions to accurately reflect patient severity of illness (i.e., hierarchal condition category [HCC] coding) and risk of high-cost care. 

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Initial Preventive Physical Examination (IPPE)

As part of the Affordable Care Act, Medicare provides coverage for an IPPE for patients who have been enrolled in Medicare for less than one year. It is a one-time service, intended to help provide an introduction to insurance coverage, benefits, and give appropriate screening for disease detection and preventive promotion of health. The IPPE must be performed within the first 12 months after the effective date of the beneficiary's Medicare Part B coverage.

An IPPE includes the following seven components:

• A review of the beneficiary's medical and social history
• Review of the beneficiary's potential risk factors for mood disorders
• Review of the beneficiary's functional ability and level of safety
• An examination
• End-of-life planning
• Education, counseling, and referral based on the previous five components
• Education, counseling, and referral for other preventive services

Annual Wellness Visit (AWV)

As part of the Affordable Care Act, Medicare provides coverage for an AWV for patients who are enrolled in Medicare. This service may be covered as often as once per year. There are two specific types of AWV: initial and subsequent. Required elements for the initial AWV include:

• A self-reported health risk assessment
• Establishment of the beneficiary's medical/family history
• A health assessment within the office
• Establishment of current providers and suppliers of service
• Detection of any cognitive impairment that the beneficiary may have
• Establishment of a written screening schedule for the beneficiary
• Establishment of a list of risk factors and conditions for which the primary, secondary, or tertiary interventions are recommended for the beneficiary
• Furnishing of personalized health advice to the beneficiary, and a referral for further care, if appropriate

The subsequent AWV visit will be updating the patient's past history as established during the initial visit, as well as a new assessment to establish any needed additional treatment. This is a shorter established service. Required elements for subsequent AWVs include:

• Update of the self-reported risk assessment
• An update of the beneficiary's medical/family history
• Update of the list of current providers and suppliers of service
• Update of the written screening schedule for the beneficiary
• Update of the list of risk factors and conditions for which the primary, secondary, or tertiary interventions are recommended for the patient
• Furnishing of personal health advice to the beneficiary, and a referral for further care, if appropriate

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The Complete Guide to the IPPE Medicare Wellness Visit

Read below for all the necessary IPPE codes, billing information, and examination steps.

Table of Contents

Navigate to a desired section with the links below or read at your own pace. 

• Quick What is the IPPE?

Why the IPPE Matters for Rural Health Clinics

• Breaking Down the IPPE

9 Components of the IPPE

• IPPE Coding, Diagnosis, & Billing

Article Sources

Additional resources, quick, what is the initial preventative physical examination (ippe) exam.

At its core, the Initial Preventative Physical Examination, or IPPE, is a review of all medical and social health history with additional preventive services and healthcare education. However, the IPPE does not include an extensive physical examination. This ‘exam’ or service, focuses more on health promotion and disease prevention and detection. The IPPE is an opportunity for physicians to improve the patient’s quality of care, create care coordination plans, and illuminate any health concerns.

Who Can Perform It?

• Physician (MD or DO)
• Qualified NPP (CNS, NP, PA)

What’s Covered?

• The exam is covered only once within 12 months of first Part B enrollment
• The patient will pay nothing (if provider accepts assignment)

As many providers are aware, Rural communities have higher rates of chronic diseases and illnesses. But patients have less access to care and healthcare education. Many patients wait a long time to treat their illness, or don’t come into their nearest Rural Health Clinic until they are already sick. That’s why exams like the IPPE are so crucial to improving patient care and quality of life. Know that the patient engagement and education component to this exam can be done in tandem with other visits.  The IPPE is an opportunity to create change in the community through preventative medicine. 

Breaking Down the Initial Preventive Physical Examination (IPPE)

The IPPE is known as the “Welcome to Medicare” preventive visit. Medicare pays for 1 patient IPPE per lifetime, no later than the first 12 months after the patient’s Medicare Part B benefits eligibility date.

During a visit, you might recommend that a patient receives these services more often than Medicare offers, or you might recommend additional services that Medicare doesn’t cover. If this is the case, please ensure that patients understand they may pay some or all the cost. Communication is key to making sure patients understand why you’re recommending certain services, and whether Medicare pays for them.

22 Tips and Tricks to Increase Practice Reimbursments

According to the 2019 Rural Health IT Survey, declining reimbursements along with improving billing processes and managing denials are two of the top three pain points healthcare organizations face.

Download our guide to learn more about managing denials, charge captures, and patient collections. 

• Past medical and surgical history (experiences with illnesses, hospital stays, operations, allergies, injuries, and treatments)
• Current medications and supplements (including calcium and vitamins)
• Family history (review of medical events in the patient’s family, including hereditary conditions that place them at increased risk)
• Physical activities
• History of alcohol, tobacco, and illegal drug use. For more information about Medicare Substance Use Disorder (SUD) services coverages, read on in this booklet.
• Select from various standardized screening tools designed for this purpose and recognized by national professional medical organizations. Find more information on depression screening on this depression assessment website.
• Ability to perform Activities of Daily Living (ADLs)
• Hearing impairment
• Home safety
• Body Mass Index (BMI) (or waist circumference, if appropriate)
• Blood pressure
• Visual acuity screen
• Other factors deemed appropriate based on medical and social history and current clinical standards
• Their ability to prepare a plan in case of an injury or illness prevents them from making health care decisions.
• Review their potential Opioid Use Disorder (OUD) risk factors
• Evaluate their pain severity and current treatment plan
• Provide information on non-opioid treatment options. Refer to a specialist, as appropriate. Find more information on pain management in the HHS Pain Management Report.
• Review the patient’s potential risk factors for SUDs and, as appropriate, refer them for treatment. A screening tool isn’t required but you may use one.
• Find more information on the National Institute on Drug Abuse Screening and Assessment Tools Chart
• Based on the results of the review and evaluation services in the previous components, administer appropriate education, counseling, and referral.
• A once-in-a-lifetime screening electrocardiogram (ECG/EKG), as appropriate
• Appropriate screenings and other preventive services Medicare covers in the Annual Wellness Plan

IPPE Coding, Diagnosis, & Billing

Use these HCPCS codes to file IPPE and ECG/EKG screening claims:

G0402 – Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment 

G0403 – Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report 

G0404 –  Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination

G0405 – Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination

G0468 –  Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv 

3 Strategies for Healthcare Success

Healthcare providers, facilities, and communities faced challenges like never before during the 2020 pandemic. Now more than ever it’s important to find ways to gain lost revenue, stay engaged with patients, and be strategic for long-term success.

Follow our tips and tricks below for success!

You must report a diagnosis code when submitting an IPPE claim. Medicare doesn’t require you to document a IPPE diagnosis code, so you may choose any diagnosis code consistent with the patient’s exam.

Medicare Part B covers an IPPE when performed by a:

• Physician (a Doctor of Medicine or Osteopathy)
• Qualified Non-Physician Practitioner (NPP) (a Physician Assistant [PA], Nurse Practitioner [NP], or Certified Clinical Nurse Specialist [CCNS]

When you provide an IPPE along with a separately identifiable and medically necessary Evaluation and Management (E/M) service, Medicare might help cover the E/M service.  Report the additional CPT code (99201–99215) with modifier –25. 

What are the other Medicare Part B preventive services?

• Advance Care Planning (ACP) as an Optional AWV Element
• Alcohol Misuse Screening & Counseling
• Annual Wellness Visit (AWV)
• Bone Mass Measurements
• Cardiovascular Disease Screening Tests
• Colorectal Cancer Screening
• Counseling to Prevent Tobacco Use
• Depression Screening
• Diabetes Screening
• Diabetes Self-Management Training (DSMT)
• Flu, Pneumococcal, & Hepatitis B Shots and their Administration
• Glaucoma Screening
• Hepatitis B Screening
• Hepatitis C Screening
• Human Immunodeficiency Virus (HIV) Screening
• Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD)
• IBT for Obesity
• Initial Preventive Physical Examination (IPPE)
• Lung Cancer Screening
• Medical Nutrition Therapy (MNT)
• Medicare Diabetes Prevention Program (MDPP)
• Prolonged Preventive Services
• Prostate Cancer Screening
• Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests
• Screening for Sexually Transmitted Infections (STIs) & High Intensity Behavioral Counseling (HIBC) to Prevent STIs
• Screening Mammography
• Screening Pap Tests
• Screening Pelvic Examination (includes a clinical breast examination)
• Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

Is the IPPE the same as a patient’s yearly physical?

No. The IPPE isn’t a routine physical that some older adults may get periodically from their physician or other qualified Non-Physician Practitioner (NPP). This exam is an introduction to Medicare and its covered benefits. Additionally, it focuses on health promotion, disease prevention, and detection to help patients stay well. The SSA explicitly prohibits Medicare coverage for routine physical examinations.

Are clinical laboratory tests part of the IPPE?

No. The IPPE doesn’t include clinical laboratory tests, but you may make appropriate referrals for these tests as part of the IPPE.

Does the deductible or coinsurance/copayment apply for the IPPE?

No. Medicare waives both the coinsurance/copayment and the Medicare Part B deductible for the IPPE (HCPCS code G0402). Neither is waived for the screening electrocardiogram (ECG/EKG) (HCPCS codes G0403, G0404, or G0405).

If a patient enrolls in Medicare in 2020, can they get the IPPE in 2021 if it wasn’t performed in 2020?

A patient who hasn’t had an IPPE and whose initial enrollment in Medicare Part B began in 2020 is eligible for an IPPE in 2021, as long as it’s within 12 months of the patient’s first Medicare Part B enrollment effective date.

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G0402: Medicare Preventive Visit

Medicare covers a one-time Initial Preventive Physical Examination (IPPE), also referred to as the “Welcome to Medicare” visit.  IPPE is a unique benefit available only to patients newly enrolled in the Medicare Program and must be received within the first 12 months of the effective date of their Medicare Part B coverage.(This is a one time benefit.)

The IPPE is a preventive physical examination and is not a “routine head to toe physical checkup”  The goals of this benefit are health promotion and disease detection and include education, counseling, and referral for other screening and preventive services also covered under Medicare Part B. The IPPE is best furnished to a patient when their health status is stable and they are open to discussing preventive and screening services.

The IPPE does not include any clinical laboratory tests. The physician (doctor of medicine or osteopathy), qualified non-physician practitioner ( a physician assistant, nurse practitioner or clinical nurse specialist).  These services are typically provided in a physician office. When the services are provided in a facility, the following institutions can bill:

• Hospitals for inpatients (TOB 12X) and outpatients (TOB 13X)
• Skilled Nursing Facilities for inpatients (TOB 22X)
• Rural Health Centers (TOB 71X)
• Federally Qualified Health centers (TOB 77X)
• Critical Access Hospitals (TOB 85X)

Coding procedure code G0402: Initial Preventive Physical Examination; face-to-face visit, services limited to a new patient during the first 12 months of Medicare enrollment.

The screening EKG/ ECG is billable with HCPCS code(s) G0403,G0404, or G0405, when it is a result of a referral from an IPPE.  The screening EKG/ECG G-code(s) is only covered once during the patient’s lifetime, the deductible and coinsurance still applies to screening EKG (G0403, G0404, abd G0405).  The IPPE code does not include other preventative services that are currently paid separately.

Although providers must report a diagnosis code on the claim, there are no specific ICD-9-CM that are required for the IPPE and EKG/ ECG screening. Providers should choose the appropriate diagnosis code, for example, diagnosis code V70.0, V70.3, or V70.9 could be considered an acceptable diagnosis.

When physicians and/or non-physician practitioner provide a significant, separately identifiable medically necessary E/M service in addition to the IPPE, they may use CPT codes 99201-99215.

The E/M code should be reported with modifier -25, to identifying the service as significant, separately identifiable.  Cost sharing will apply to the E/M service.

If the primary physician does not perform a screening EKG/ ECG, as a result of the IPPE, another physician or entity may perform and/or interpret the EKG/ ECG. The referring provider should ensure that the performing provider bills the appropriate HCPCS G-code and not a CPT 93000 series, they shall document the results in the patients medical record to complete and bill for the IPPE benefit.

Should an additional medically necessary EKG in the 93000 series need to be performed on the same day as the IPPE, report the appropriate EKG CPT codes(s) with modifier -59.  This will indicate that the additional EKG is a distinct procedural service.

The Medicare IPPE exam includes seven elements.  The exam focuses on identifying modifiable risk factors for medical conditions that frequently affect the elderly, as well as education, counseling and referral for Medicare screening services.

The following are the seven elements of Medicare IPPE exam:

1 Review of medical and social history with attention to modifiable risk factors for disease detection.

Medical history includes, at a minimum, past medical and surgical history, including experiences with illness, hospital stays, operations, allergies, injuries, and treatments; current medications and supplements, including calcium and vitamins;

family history, including a review of medical events in the patients family, including diseases that are hereditary or place the patient at risk.

Social history includes, at a minimum, history of alcohol, tobacco, and illicit drug use, diet and physical activities.

2 Review of the patients potential risk factors for depression and other mood disorders.

This includes current and past experiences with depression or other mood disorders, based on the use of an appropriate screening instrument for persons without a current diagnosis of depression.  The provider may select from a various available screening questions or standardized questionnaires designed for this purpose and recognized by national professional medical organizations.  Many standardized screening tools are too cumbersome to use in a short office visit. One quick technique recommended by the U.S. Preventive Services Task Force (USPSTF) involves asking two questions: “over the past two weeks, have you felt down, depressed or hopeless?’ and “Over the past two weeks, have you felt little interest or pleasure in doing things?” An affirmative answer to either may be as effective as more detailed instruments identifying a patient who needs further evaluation for depression.

3.Review of functional ability and level of safety

 The provider has a lot of leeway with this element, which requires an evaluation of the patient’s hearing, activities of daily living, functional ability and level of safety.

For determining fall risk, according to the AGS (American Geriatrics Society), there are two tests that should trigger further patient evaluation: if your patient previously has received treatment for a fall, or if your patient takes longer than 30 seconds for an “Up & Go” test.

The timed Up & Go test involves having the patient stand up from a chair, walk three meters, turn around, walk back to the chair and sit back down. If the patient takes longer then 30 seconds or seems unsteady, the test is considered positive for increased fall risk.

To identify functional challenges, the CDC advises screening your patients by inquiring about their instrumental activities of daily living (IADLs). This involves asking patients about troubles using a phone, using transportation, grocery shopping, preparing meals, doing housework, doing laundry, taking medications and managing money. Any limitation to their IADLs that you identify as being caused by a chronic condition warrants further evaluation.

The CDC recommends that elderly patients improve home safety by removing tripping hazards in walkways, using non-slip mats in bathtubs and showers, placing grab bars next to the toilet and shower, placing handrails on both sides of a stairway and improving home lighting. It seems reasonable to question patients about these items during the initial preventive physical exam.

For the hearing evaluation, you can follow the USPSTF’s recommendation to simply question patients about their hearing function. There are, of course, more elaborate testing methods, but the USPSTF found insufficient evidence to recommend for or against them.

Your screening for depression risk, functional ability and level of safety should be accompanied by further evaluation, including a full diagnostic workup, for any patients with positive responses. The workup can be performed in conjunction with the initial preventive physical exam, or the patient can be further evaluated later. CMS will allow a level-one or level-two E/M code with a -25 modifier attached to be billed with the initial preventive physical exam. If you conclude that the depression or fall risk does not warrant immediate care but will require a level-three or higher E/M service, it might be prudent to perform the full workup at a later date.

4. An Examination

 A focused physical exam. This should be an extremely focused physical exam. Height, weight, blood pressure, body mass index, and visual acuity are the only required components. No specific vision tests are mandated, but using the Snellen chart is appropriate.

5. End-of-life planning

End of life planning is as required service, upon the patient’s consent.  End of life planning is a verbal or written information provided to the beneficiary regarding the patient’s ability to prepare and advance directive in the case that an injury or illness causes the beneficiary to be unable to make health care decisions, and whether or not the physician is willing to follow the patient’s wishes as expressed in the advance directive.

6. Education, counseling, and referral based on the previous five components

 Brief education, counseling and referral to address any pertinent health issues identified during the first five elements of the exam (e.g diet, chronic illness, and smoking or alcohol use).  CMS expects the amount of time required for this step to vary depending on the problems that you discovered in the first five elements.

7. Education, counseling, and referral for other preventive services

Brief education, counseling and referral, with maintenance of a written plan (such as a checklist), regarding separate preventive care services covered by Medicare Part B. There are now 11 preventive services authorized under Medicare Part B. Other covered preventive that are performed may be billed in addition to HCPCS code G0402 and the appropriate EKG G-code (influenza vaccine, mammogram, ect.)

Performance and interpretation of an electrocardiogram. Some offices have the capacity to handle this, and others will need to send the patient to another facility. Either way, the EKG/ECG results need to be incorporated into your patient’s medical record to complete the initial preventive physical exam.

If the patient is sent to another facility for the EKG/ ECG, the order must read “EKG/ECG as part of the Welcome to Medicare Physical, codes G0366–G0368.” Medicare has instructed that physicians must order the EKG/ECG in a manner that helps to prevent use of codes for EKG/ECGs not related to the initial preventive physical exam.

PREVENTIVE SERVICES COVERED BY MEDICARE PART B

• Pneumococcal, influenza and hepatitis B vaccines
• Screening mammography
• Screening Pap smear/pelvic exam
• Prostate cancer screening
• Colorectal cancer screening
• Diabetes outpatient self-management training services
• Bone mass measurements
• Screening for glaucoma
• Medical nutritional therapy for individuals with diabetes or renal disease
• Cardiovascular screening blood tests
• Diabetes screening tests

It is important that you thoroughly understand Medicare’s policy on these services before counseling your patient. Some services are covered at 100 percent of the Medicare allowable charge, and some services are covered at 80 percent of the Medicare allowable charge. In addition, some of the services are covered only if medically indicated. The IPPE will be paid at the appropriate physician fee schedule based on the rendering National Provider Identification (NPI) number.

For additional information see the following links:

ABC’s of Providing the Initial Preventive Physical Examination

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QRI_IPPE001a.pdf

Guide to Medicare preventive services

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/mps_guide_Web-061305.pdf

--- Michelle Herbert, CPC is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding.

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Initial preventive physical examination with ekg (ippe), welcome to medicare preventive visit, hcpcs/cpt codes.

• G0402 –   Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
• G0403 – Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
• G0404 – Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
• G0405 –   Electrocardiogram, routine ECG with 12 leads; interpretation and report only , performed as a screening for the initial preventive physical examination

Who Is Covered

• All new Medicare beneficiaries who are within the first 12 months of their first Medicare Part B coverage period
• Once in a lifetime
• Must furnish no later than 12 months after the effective date of the first Medicare Part B coverage period

Covered ICD-10 Codes for CPT G0402

The specified below ICD codes are covered for CPT G0402 but may not be limited and some private payers having specific guidelines.

• R93.811 Abnormal radiologic findings on diagnostic imaging of right testicle
• R93.812 Abnormal radiologic findings on diagnostic imaging of left testicle
• R93.813 Abnormal radiologic findings on diagnostic imaging of testicles, bilateral
• R93.819 Abnormal radiologic findings on diagnostic imaging of unspecified testicle
• R93.89 Abnormal findings on diagnostic imaging of other specified body structures
• Z00.00 Encounter for general adult medical examination without abnormal findings
• Z00.01 Encounter for general adult medical examination with abnormal findings
• Z00.8 Encounter for other general examination
• Z01.00 Encounter for examination of eyes and vision without abnormal findings
• Z01.01 Encounter for examination of eyes and vision with abnormal findings
• Z01.020 Encounter for examination of eyes and vision following failed vision screening without abnormal findings
• Z01.021 Encounter for examination of eyes and vision following failed vision screening with abnormal findings
• Z01.10 Encounter for examination of ears and hearing without abnormal findings
• Z01.110 Encounter for hearing examination following failed hearing screening
• Z01.118 Encounter for examination of ears and hearing with other abnormal findings
• Z68.1 Body mass index [BMI] 19.9 or less, adult
• Z68.20 Body mass index [BMI] 20.0-20.9, adult
• Z68.21 Body mass index [BMI] 21.0-21.9, adult
• Z68.22 Body mass index [BMI] 22.0-22.9, adult
• Z68.23 Body mass index [BMI] 23.0-23.9, adult
• Z68.24 Body mass index [BMI] 24.0-24.9, adult
• Z68.25 Body mass index [BMI] 25.0-25.9, adult
• Z68.26 Body mass index [BMI] 26.0-26.9, adult
• Z68.27 Body mass index [BMI] 27.0-27.9, adult
• Z68.28 Body mass index [BMI] 28.0-28.9, adult
• Z68.29 Body mass index [BMI] 29.0-29.9, adult
• Z68.30 Body mass index [BMI] 30.0-30.9, adult
• Z68.31 Body mass index [BMI] 31.0-31.9, adult
• Z68.32 Body mass index [BMI] 32.0-32.9, adult
• Z68.33 Body mass index [BMI] 33.0-33.9, adult
• Z68.34 Body mass index [BMI] 34.0-34.9, adult
• Z68.35 Body mass index [BMI] 35.0-35.9, adult
• Z68.36 Body mass index [BMI] 36.0-36.9, adult
• Z68.37 Body mass index [BMI] 37.0-37.9, adult
• Z68.38 Body mass index [BMI] 38.0-38.9, adult
• Z68.39 Body mass index [BMI] 39.0-39.9, adult
• Z68.41 Body mass index [BMI] 40.0-44.9, adult
• Z68.42 Body mass index [BMI] 45.0-49.9, adult
• Z68.43 Body mass index [BMI] 50.0-59.9, adult
• Z68.44 Body mass index [BMI] 60.0-69.9, adult
• Z68.45 Body mass index [BMI] 70 or greater, adult
• Z71.84 Encounter for health counseling related to travel

Covered ICD-10 Codes for CPT G0403, G0404, G0405

• R00.0 Tachycardia, unspecified
• R00.1 Bradycardia, unspecified
• R00.2 Palpitations
• R00.8 Other abnormalities of heart beat
• R00.9 Unspecified abnormalities of heart beat
• R01.0 Benign and innocent cardiac murmurs
• R01.1 Cardiac murmur, unspecified
• R01.2 Other cardiac sounds
• R03.0 Elevated blood-pressure reading, without diagnosis of hypertension
• R07.1 Chest pain on breathing
• R07.2 Precordial pain
• R07.81 Pleurodynia
• R07.82 Intercostal pain
• R07.89 Other chest pain
• R07.9 Chest pain, unspecified
• R94.31 Abnormal electrocardiogram [ECG] [EKG]
• Z13.30 Encounter for screening examination for mental health and behavioral disorders, unspecified
• Z13.31 Encounter for screening for depression
• Z13.32 Encounter for screening for maternal depression
• Z13.39 Encounter for screening examination for other mental health and behavioral disorders
• Z13.6 Encounter for screening for cardiovascular disorders
• Z82.41 Family history of sudden cardiac death
• Z82.49 Family history of ischemic heart disease and other diseases of the circulatory system

Medicare Beneficiary Pays as below,

• Co-payment/coinsurance waived
• Deductible waived

G0403, G0404, and G0405,

• Co-payment/coinsurance applies
• Deductible applies

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