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.