HIV
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G0433
HIV MS or 69991446
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No risk factors – Z11.4
Risk factors – add Z72.89,Z72.51,Z72.52 or Z72.53
Pregnancy-Z11.4 plus Z34.00, Z34.01, Z34.02, Z34.03, Z34.80, Z34.81, Z34.82, Z34.83, Z34.90, Z34.91, Z34.92, Z34.93, O09.90, O09.91, O09.92, or O09.93
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*Increased risk for HIV
*Pregnant women
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*Annually for those between ages of 15-65 w/out regard to risk
*Annually for patients younger than 15 or older than 65 with increased risk.
*3 times per pregnancy
-at diagnosis
-third trimester
-at labor
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Sexually Transmitted Infections |
86631, 86632, 87110, 87270, 87320, 87490, 87491, 87810 – Chlamydia
87590, 87591, 87850 - Neisseria gonorrhea
87800 - Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique
86592 - Syphilis test, nontreponemal antibody; qualitative (e.g., VDRL, RPR, ART)
86593 - Syphilis test, nontreponemal, quantitative
86780 - Treponema pallidum
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Z11.3, Z72.89, Z72.51, Z72.52, Z72.53, Z34.00, Z34.01, Z34.02, Z34.03, Z34.80, Z34.81, Z34.82, Z34.83, Z34.90, Z34.91, Z34.92, Z34.93, O09.90, O09.91, O09.92, and O09.93
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When all is true:
*sexually active with increased risk
*referred and provided by Medicare eligible PCP
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Annually for chlamydia, gonorrhea, and syphilis in women at increased risk and not pregnant
Annually for syphilis in men at increased risk
Twice per pregnancy for chlamydia and gonorrhea for women with increased risk and continued risk to 2nd trimester
Once per pregnancy for syphilis in pregnant women; up to two additional occurrences in the third trimester and at delivery if at continued increased risk for STIs
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Hepatitis B |
G0499
HBV MS or 70900031
86704 - Hep B core antibody
86706 - Hep B surface antibody
87340 - Hep B surface antigen
87341 - Hep B surface antigen neutralization
no screen CPT needed for these patients
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Must have both Z11.59 AND Z72.89
No risk: Z11.59 and Z34.00 or Z34.80 or Z34.90 or O09.90
At risk: Z11.59 and Z72.89 and one of the following:
Z34.00-Z34.03
Z34.80-Z34.83
Z34.90-Z34.93
O09.90-O09.93
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High risk, asymptomatic non-pregnant adolescents and adults
Pregnant beneficiaries
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Annually as long as the risk continues.
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