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Tag Archives: Screening

USPSTF Recommends Screening Adults for Anxiety Disorders

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Adults 19-64 may benefit from routine screenings by PCPs. The U.S. Preventive Services Task Force (USPSTF) has recommended that all adults ages 19-64, including pregnant and postpartum persons, be screened regularly for anxiety disorders by their primary care physician (PCP). There was not enough evidence to back screening for adults 65 and older, according to […]

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AAPC Knowledge Center

Colorectal Screening Cost-Sharing Changes Are Coming

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Colonoscopies that require additional related procedures will soon see a change in Medicare coinsurance. A provision of the Consolidated Appropriations Act (CAA) of 2021 has put Medicare patients on a gradual coinsurance reduction plan for certain colorectal cancer screening tests that turn into a diagnostic or therapeutic service. Currently, the addition of any procedure beyond […]

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AAPC Knowledge Center

A New Age for Colorectal Cancer Screening

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Regular screening now covered at age 45 for some health plans. According to the American Cancer Society (ACS), colorectal cancer is the third most common cancer diagnosed in the United States. The risk of developing colon cancer is about one in 23 in men and one in 25 in women. In 2022, an estimated 106,180 […]

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AAPC Knowledge Center

USPSTF Reconsiders Diabetes Screening Age

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Is 40 too late to start diabetes screening? In a statement released March 16, 2021, the U.S. Preventive Services Task Force (USPSTF) issued new recommendation guidelines for prediabetes and type 2 diabetes screenings. Taking into account epidemiologic evidence, the USPSTF now recommends lowering the initial screening age from 40 to 35 years. (This is currently […]

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Recommendations for Abdominal Aortic Aneurysm Screening

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Ruptured abdominal aortic aneurysm (AAA) ranks as the 15th leading cause of death in the United States and the 10th leading cause of death in men older than 55 years. Abdominal aortic aneurysm screenings have shown a measurable and significant reduction in the overall rate of aneurysm-related death. In this article, we’ll review the U.S. Preventive […]

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Cardiovascular Screening: Combating the World’s #1 Killer

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Cardiovascular disease is the world’s number one killer today, but it doesn’t need to be this way. September is National Cholesterol Education Month and September 29 is World Heart Day. These observances raise awareness about cardiovascular disease (CVD), cholesterol, and stroke, encouraging individuals, families, communities, and governments to take action now. Join the movement and […]

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Coding Prostate Cancer Screening

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Every 17 minutes another man dies from prostate cancer in the United States. September is National Prostate Cancer Awareness Month and a great time to help raise awareness about this disease. Prostate cancer is the most common cancer and the second leading cause of cancer death among American men. In 2019, nearly 175,000 men will […]

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Coding Guidelines for Hepatitis B Screening – Reimbursement Tips

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This would help your organization join the fight against Hepatitis B (HBV) infection by understanding what conditions are necessary for coverage of HBV screening and how to properly code the Hepatitis B surface antigen (HBsAg) serologic test.

Conditions for Coverage of HBsAg Serologic Testing:

The patient’s primary care physician or practitioner,  an eligible Medicare provider, must order the screening within the context of a primary care setting.

The screening must be performed by appropriate U.S. Food and Drug Administration (FDA) approved/cleared laboratory tests, used consistent with FDA approved labeling and in compliance with the Clinical Laboratory Improvement Act (CLIA) regulations.

Patients must be either,
  • Pregnant – A screening test at the first prenatal visit is covered and then re-screening at time of delivery for those with new or continuing risk factors.
    • Screening for each pregnancy, regardless of previous hepatitis B vaccination or previous negative HBsAg test results
  • Asymptomatic, nonpregnant adolescent/adult at high risk for HBV infection.
    • Coverage provides one screening annually.

Procedure Coding for HBV Screening:

86704 – Hepatitis B core antibody (HBcAb); total

86706 – Hepatitis B surface antibody (HBsAb)

87340 – Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg)

87341 – Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg) neutralization

G0499 – Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive results, and antibodies to HBSAG (anti-HBs) and Hepatitis B core antigen(anti-HBc)

Diagnosis Coding for HBV Screening:

For HBV screening in pregnant women (CPT codes 86704, 86706, 87340 and 87341) report Z11.59 Encounter for screening for other viral diseases with one of the following diagnosis codes,

Z34.00 – Encounter for supervision of normal first pregnancy, unspecified trimester
Z34.80 – Encounter for supervision of other normal pregnancy, unspecified trimester
Z34.90 – Encounter for supervision of normal pregnancy, unspecified, unspecified trimester
O09.90 – Supervision of high risk pregnancy, unspecified, unspecified trimester

For HBV screening in pregnant women at high risk, report the appropriate CPT code with Z11.59, Z72.89 Other problems related to lifestyle and one of the following ICD-10-CM codes, as appropriate,

Z34.00 – Z34.03 – Encounter for supervision of normal first pregnancy
Z34.80 – Z34.83 – Encounter for supervision of other normal pregnancy
Z34.90 – Z34.93 – Encounter for supervision of normal pregnancy, unspecified
O09.90 – O09.93 – Supervision of high risk pregnancy, unspecified

For non-pregnant adolescents/adults at high risk for HBV infection, CMS will allow coverage for G0499 only when services are reported with the following diagnosis codes denoting high risk,

Z11.59 – Encounter for screening for other viral disease
Z72.89 – Other Problems related to lifestyle

CMS will allow coverage for G0499 for subsequent visits when reported with Z11.59 and one of the following high-risk codes, as appropriate,

F11.10-F11.99
F13.10-F13.99
F14.10-F14.99
F15.10-F15.99
Z20.2
Z20.5
Z72.52
Z72.53

Additional Information:

For claims with dates of service on or after September 28, 2016, CMS will allow coverage for HBV screening only when submitted with one of the following Place of Service (POS) codes,

  • 11 – Physician’s Office
  • 19 – Off Campus Outpatient Hospital
  • 22 – On Campus Outpatient Hospital
  • 49 – Independent Clinic
  • 71 – State or Local Public Health Clinic
  • 81 – Independent Laboratory

Claims submitted without one of the POS codes noted above will be denied. 

For claims with dates of service on or after September 28, 2016, CMS will allow coverage for HBV screening only when services are submitted by the following provider specialties found on the provider’s enrollment record,

  • 01 – General Practice
  • 08 – Family Practice
  • 11 – Internal Medicine
  • 16 – Obstetrics/Gynecology
  • 37 – Pediatric Medicine
  • 38 – Geriatric Medicine
  • 42 – Certified Nurse Midwife
  • 50 – Nurse Practitioner
  • 89 – Certified Clinical Nurse Specialist
  • 97 – Physician Assistant

Claims submitted by providers other than the specialty types noted above will be denied. 

Source: https://www.aapc.com/blog/48106-coding-hepatitis-b-screening/

Click Here for more Information about Hepatitis Screening 


Coding Ahead

Stop Hepatitis B via HBsAg Screening in Pregnant Women

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Screening for Hepatitis B (HBV) infection in pregnant women provides substantial benefit, reaffirms the U.S. Preventive Services Task Force (USPSTF) in their recommendation statement released last month. This determination follows their review of new evidence on the benefits and risks of screening for hepatitis B surface antigen (HBsAg). Serologic testing accurately identifies HBV infection and, in turn, women whose infants are at risk of perinatal transmission. Interventions provided to HBV-positive pregnant women are effective in preventing perinatal transmission of HBV and the subsequent development of chronic HBV infection.

HBV Significance:

HBV is a leading cause of death worldwide. Chronic HBV infection is associated with increased morbidity and mortality, often leading to cirrhosis and liver cancer. 

Prevention of mother-to-child transmission is an integral part of global efforts to mitigate the burden of chronic HBV since vertical transmission is responsible for approximately one-half of chronic infections globally. 

An estimated 24,000 infants are born each year to women in the United States infected with HBV.

Although there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5 percent since 1998. Without postexposure immunoprophylaxis, approximately 40 percent of infants born to HBV-infected mothers in the United States will develop chronic HBV infection, approximately one-fourth of whom will eventually die from chronic liver disease, according to the Centers for Disease Control and Prevention (CDC).

HBsAg Testing Saves Lives:

The CDC has recommended routine prenatal screening for hepatitis B infection since 1988. The principal screening test for detecting maternal HBV infection is the serologic identification of HBsAg. Immunoassays for detecting HBsAg have a reported sensitivity and specificity greater than 98 percent.

Prevent perinatal HBV transmission by identifying HBV-infected pregnant women via HBsAg testing and provide targeted HBV immunoglobulin (HBIG) and vaccination postdelivery for infants born to HBsAg–positive mothers.

USPSTF Reviews Substantial Evidence:

To reaffirm its 2009 recommendation on HBV screening in pregnant women, the USPSTF commissioned a reaffirmation evidence update to identify substantial new evidence sufficient enough to change the prior recommendation. 

In the United States, the standard intervention for all HBV-positive pregnant women is case management. Thus, USPSTF’s evidence review focused on the benefits and risks of screening and the effectiveness and potential harms of case management in the prevention of perinatal transmission.

The net benefit of screening continues to be well established. Mounting evidence proves that serologic testing for HBsAg accurately identifies HBV infection and interventions are successful in preventing perinatal transmission. In fact, studies showed a decrease in perinatal transmission among women and infants enrolled in case management.

Source: https://www.aapc.com/blog/48069-hbsag-screening-in-pregnant-women/


Coding Ahead