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Family Practice Coding Alert

7 Stratigies for Superior Screening Reimbursement

Presented by Susan Pincus, CPC, CHC

The following supplement to Family Practice Coding Alert is the transcript of a teleconference presented by The Coding Institute. To obtain the slides for the conference, please log on to our Online Subscription System at and download the current issue, and the slides will be contained therein. If you-re not sure how to use the Online Subscription System or need help downloading the issue, please contact our customer service department at 1-800-508-2582 or, and one of our representatives will be able to assist you.

The speaker for the teleconference, Susan Pincus, CPC, CHC, has over 17 years of healthcare coding and reimbursement experience, almost all of which has been in a multi-specialty environment. She was a healthcare compliance professional in a large academic medical center and currently has her own healthcare consulting practice. She is on the National Advisory Board of the American Academy of Professional Coders (AAPC), and is certified by the AAPC and the Health Care Compliance Association (HCCA). She is also an approved PMCC instructor. In 1997, the AAPC honored Susan with their prestigious National Coder of the Year award. Today I will be sharing with you some information regarding how you can bill and get reimbursed for preventive medicine visits and for screening tests.  We are going to cover first the Medicare Initial Preventive Physical Examination or the IPPE, then I am going to talk about new screening services covered by Medicare for 2005.  I will mention proposed smoking cessation counseling by Medicare.  Then I will review some other preventive and screening services covered by Medicare.  Then I will switch gears a little bit and go into the preventive medicine visit, talk about it and then I am going to provide several preventive medicine scenarios and tell you how to code those scenarios.  We will talk about the advantages as well as the challenges of using preventive medicine codes and then we will talk about the combined problem-based and preventive visit and I will also provide several combination problem visit and preventive medicine visit scenarios and talk about how they should be coded.  And then at the very end I am going to give you two examples of visits that we will code together.

First let me give you the scoop on the new Welcome to Medicare Exam or officially the Medicare Initial Preventive Physical Exam or the IPPE.  This exam affects Medicare patients newly enrolled as of 01/01/05.  For example, if a Medicare patient enrolled in Medicare on 01/01/05 they have until 07/01/05 to get their IPPE.  Medicare will allow one preventive medicine visit only during [...]

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