decisionhealth Newsletters, Answer Books - 2011 Issue 7 (July)
Preventive Medicine / Medicare preventive coverage at-a-glance
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Article Overview
This article provides a broad Medicare preventive coverage reference for clinicians, coders, and billing staff. It organizes major preventive services by category and summarizes the types of coverage information typically needed to evaluate eligibility, frequency, cost-sharing status, and related diagnostic code reporting for preventive medicine services.
Why This Topic Matters
Medicare preventive services are governed by service-specific coverage rules and coding details that affect whether a claim is payable and how it is reported. This reference helps users quickly determine which preventive service areas are addressed and what general billing fields are included in the coverage overview.
Article Sections
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Initial Preventive Physical Exam (IPPE)
Introduces the Medicare preventive physical exam category and the general coverage information presented for it.
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Optional Screening ECG as Part of IPPE
Covers the related preventive electrocardiogram screening information associated with the initial preventive exam.
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Abdominal Aortic Aneurysm (AAA) as Part of IPPE
Summarizes the preventive screening category for abdominal aortic aneurysm in connection with the initial exam.
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Annual Wellness Visit
Outlines the Medicare annual wellness visit category and the coverage fields shown for initial and subsequent visits.
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Bone Mass Measurement – Screening
Lists the bone density screening coverage category and the related test types referenced in the article.
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Cardiovascular Screening Tests
Describes the preventive cardiovascular screening category and the laboratory tests included in the coverage summary.
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Colorectal Cancer Screening
Presents colorectal cancer screening services and the preventive coverage information provided for multiple service types.
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Diabetes Screening & Self-Management Training
Covers diabetes screening tests and diabetes self-management training services as organized in the preventive coverage reference.
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Medical Nutrition Therapy (MNT) Services
Summarizes the nutrition therapy services section and the general coverage information tied to qualified beneficiaries.
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Glaucoma Screening
Lists the glaucoma screening preventive category and the high-risk screening information shown in the article.
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HIV Screening
Covers the HIV screening services and the preventive coverage details presented for beneficiaries at risk or during pregnancy.
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Mammography – Screening
Summarizes the screening mammography category and the coverage information shown for different beneficiary groups.
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Screening Pap Smear, Pelvic & Breast Exam
Covers cervical and pelvic preventive screening services and the related coverage information presented in the article.
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Prostate Cancer Screening
Outlines the prostate cancer screening preventive category and the general Medicare coverage fields provided.
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Smoking and Tobacco Cessation Counseling
Describes the smoking cessation counseling preventive service category and the coverage summary included.
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Vaccines – Hepatitis B
Covers hepatitis B vaccination and administration as presented in the preventive coverage reference.
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Vaccines – Influenza
Summarizes influenza vaccine products and administration information included in the Medicare preventive coverage overview.
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Vaccines – Pneumonia
Covers pneumococcal vaccination and administration information as organized in the article.
What You Will Learn
- Which Medicare preventive service categories are included in the overview
- What kinds of coverage fields are used to summarize preventive services
- How the article groups screening, counseling, and vaccination topics
- Which preventive areas are addressed for common Medicare populations
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Primary care practices
- Preventive medicine clinicians
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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