Professional Billing Requirements for Screening for Hepatitis C Virus (HCV) (Rev. 3215, 01-05-15)

by  Jared Staheli
July 7th, 2015

For claims with dates of service on or after June 2, 2014, Medicare will allow coverage for HCV screening, HCPCS G0472, only when services are ordered 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

HCV screening services ordered by providers other than the specialty types noted above will be denied.

For claims with dates of service on or after June 2, 2014, Medicare will allow coverage for HCV screening, HCPCS G0472, only when submitted with one of the following place of service (POS) codes:

11 – Physician’s Office

22 – Outpatient Hospital

49 – Independent Clinic

71 – State or Local Public Health Clinic

81 – Independent Laboratory

HCV screening claims submitted without one of the POS codes noted above will be denied.

References:

Professional Billing Requirements for Screening for Hepatitis C Virus (HCV) (Rev. 3215, 01-05-15). (2015, July 7). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/professional-billing-requirements-for-screening-for-hepatitis-c-virus-hcv-rev-3215-01-05-15-27089.html

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