Know Medicare screening services fully - CPT and covered DX

Summary of Medicare Screening Services

Possible Procedure/HCPCS Codes	Coverage	Patient Criteria	Patient Financial Responsibility	Provider Criteria	Possible Diagnosis Codes
Screening Pelvis Examination
G0101	Every 2 years	Not high risk	20 % allowable No Part B deductible	None stated	V76.2, V76.47, V76.49, V72.31
	Annually	High risk			V15.89
Collection of Pap Smear Specimen
Q0091	Every 2 years	Not high risk	20 % allowable No Part B deductible	None stated	V76.2, V76.47, V76.49, V72.31
	Annually	High risk			V15.89
Screening Hemoccult
82270 G0328	Annually	>50 years old	None	None stated	V76.51, V76.41
Screening Mammography
77057, +77052 G0202	Annually	>40 years old	20 % allowable No Part B deductible	None stated	V76.12, V76.11
Screening Bone Mass Measurement
77078, 77079, 77080, 77081, 77083, 76977, G0130	Once every 24 months	Patients at risk	20% allowable Deductible applies	Test ordered by physician or qualifed non physician practitioner who is treating patient.	Determined by Local Carriers*
Initial Preventive Physical Examination (Welcome to Medicare Examination)
G0402, G0403, G0404, G0405	Once	Within first 12 months of Medicare coverage	20% allowable Deductible waived, but co-insurance provision apply	Test ordered by physician or qualifed non physician practitioner who is treating patient.	V070.0
Diabetes Screening
82947, 82950, 82951	Twice in 12 month period	Patients at risk	None	None stated	V77.1
Cardiovascular Screening Blood Test
82465, 84478, 83718, 80061	Every 5 years	All Medicare beneficiaries	None	Test must be ordered by physician and used in management of patient	V81.0, V81.1, V81.2
Tobacco Use Cessation Counseling
99406, 99407	2 cessation attempts in 12 month period (1 attempt=up to 4 sessions)	Patient has condition or is receiving treatment that is being adversely affected by tobacco use	20% allowable Deductible applies	Provided by a physician, physician assistant, nurse practitioner, clinical nurse specialist, qualified psychologist or clinical social worker	Use code indicating patient's condition or treatment affected by tobacco use