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.

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