Procedure Code(s): n/a This counseling service is included in a preventive care wellness examination or focused E&M visit.

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Procedure Code(s): n/a This counseling service is included in a preventive care wellness examination or focused E&M visit."

Transcription

1 Coding Summary for Providers NOTE THE FOLLOWING: The purpose of this document is to provide a quick reference of the applicable codes for UnitedHealthcare plans that cover preventive care services in accordance with the health care reform law. This resource does not replace or supersede the Preventive Care Services Coverage Determination Guideline. If there are any differences between this summary and the Preventive Care Services Coverage Determination Guideline, then the Coverage Determination Guideline takes precedence. Certain UnitedHealthcare plans do NOT use the following codes for preventive care benefits. This document does NOT apply to all UnitedHealthcare members. Please use your existing process for benefit verification such as looking up member benefit information at: UnitedHealthcareOnline.com Codes and (where listed below) are only covered as Preventive when done for a preventive lab procedure that requires a blood draw. See the Preventive Care Services Coverage Determination Guideline for complete coding instructions.. Each member s benefits are defined by his or her benefit plan documents, and any information in the following tables that is inconsistent with the applicable benefit plan documents does not constitute an additional benefit. Benefit adjudication is contingent upon accurate claims submission by the provider, including diagnosis, procedure, age and gender. See the Preventive Care Services Coverage Determination Guideline for a listing of applicable ICD-10 diagnosis codes effective on Oct. 1, 2015 Abdominal Aortic Aneurysm Anemia, Iron Deficiency Anemia Aspirin for the Prevention of Cardiovascular Disease (Counseling) 76700, 76705, 76770, 76775, G0389 Diagnosis Code(s): V , 85014, 85018, 36415, Diagnosis Code(s): Pregnancy (see list at end of section). This counseling service is included in a preventive care wellness examination or focused E&M visit. Bacteriuria Diagnosis Code(s): Pregnancy (see list at end of section). Behavioral Counseling in Primary Care to Promote a Healthy Diet , , G0270, G0271, G0446, G0447, S Diagnosis Code(s): V77.91, V15.82, V17.3, V17.49, , , V85.41 V85.45, 272.0, 272.1, 272.2, 272.3, 272.4, 401.0, 401.1, 401.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Males. Age Pregnant Pregnant Effective June 1, 2014 p. 1 of 9

2 Behavioral Counseling to Prevent Sexually Transmitted Infections Cervical Cancer, Pap Smear Chemoprevention of Breast Cancer (Counseling) Chlamydia Infection Cholesterol (Lipid Disorders ) , , , , , , , , , , , , , , , , , , , , , , , , , , 440.0, 440.1, , , , , , , , , , 440.8, 440.9, , , , , , , , , G0445 Code Group 1 (payable regardless of diagnosis code): G0101, G0123, G0124, G0141, G0143 G0145, G0147, G0148, Q0091, P3000, P3001 Code Group 2 (requires a diagnosis code from list below): , 88147, 88148, 88150, , , 88174, Diagnosis Code(s) Code Group 2: V70.0, V72.31, V72.32, V , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99385, 99386, 99387, 99395, 99396, 99397, G0463 Diagnosis Code(s): V16.3, V16.41 Diagnosis code must be in primary position , 86632, 87110, 87270, 87320, 87490, 87491, 87492, 87801, 87810, 36415, Diagnosis Code(s): V70.0, V73.88, V73.98, V74.5, V75.9, OR Pregnancy (see list at end of section) , 82465, 83718, 83719, 83721, 84478, 36415, Diagnosis Code(s) (Required for all): V70.0 or V77.91 Diagnosis Codes for increased risk for coronary heart disease (for Men 20-34, and all Women 20 and up): V15.82, V17.3, V17.49, , , V85.41 V85.45, 401.0, 401.1, 401.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 440.0, 440.1, , , , , , , , , , 440.8, 440.9, , , , , , , , limits. All males age 35 and up. Males age if at increased risk for coronary heart disease. Females age 20 and up if at increased risk for coronary heart disease. NOTE: These will only pay as preventive if there is no prior history of a lipid disorder. Effective June 1, 2014 p. 2 of 9

3 Colorectal Cancer Counseling and Interventions to Prevent Tobacco Use Fecal Occult Blood Testing, Sigmoidoscopy, or Colonoscopy: Code Group 1 (Preventive regardless of diagnosis code): G0104, G0105, G0106, G0120, G0121, G0122, G0328 Code Group 2 (Preventive if billed in addition to a Code Group 1 code, OR if billed with one of the Diagnosis codes below): Procedure Codes: 44388, 44389, 44392, 44393, 44394, 45330, 45331, 45333, 45338, 45339, 45378, 45380, 45381, 45383, 45384, 45385, 82270, Diagnosis Code(s) (for Code Group 2): V16.0, V18.51, V18.59, V70.0, V76.41, V76.50, V76.51 Code Group 3 (Pathology): 88304, (These are Preventive if billed with one of the listed diagnosis code from Code Group 2 PLUS one of the Procedure code from Code Group 1 or 2): Computed Tomographic Colonography (Virtual Colonoscopy): (Preventive regardless of diagnosis code): , 99406, 99407, G0436, G0437 Diabetes 82947, 82948, 82950, 82951, 82952, 83036, 36415, Diagnosis Code(s): V70.0 or V77.1, PLUS ONE OF THE FOLLOWING HYPERTENSION CODES: 401.0, 401.1, 401.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , See Expanded Women s Preventive Health table below for Gestational Diabetes codes. Genetic Counseling and Evaluation for BRCA Testing; and BRCA Lab Genetic Counseling and Evaluation: 96040, , , , , S0265, G0463 Diagnosis Code(s): V10.3, V10.43, V16.3, V16.41 Diagnosis code must be in primary position. BRCA Lab s: *Prior authorization requirements apply to BRCA lab screening Diagnosis Code(s): Family History: V16.3 and V16.41 This benefit only applies to patients with hypertension. NOTE: These will only pay as preventive if there is no prior history of diabetes. BRCA Lab s: Females age 18 and up with a family history of breast or ovarian cancer. Note: preventive benefits do not apply to BRCA Lab s for those that have a personal history, or current diagnosis, of breast and/or ovarian cancer. Effective June 1, 2014 p. 3 of 9

4 Gonorrhea 87590, 87591, 87592, 87801, Diagnosis Code(s): V70.0, V74.5, V75.9, OR Pregnancy (see list at end of section). Hepatitis B Virus Infection Hepatitis C Virus Infection (as of June 1, 2014) HIV Human Immunodeficiency Virus for Adolescents and Adults (Males and Females) 87340, 87341, 36415, Diagnosis Code(s): Pregnancy (see list at end of section) , 86804, 36415, Diagnosis Code(s): 042, , , , , , , , , 079.4, , , , 090.0, 090.1, 090.2, 090.3, , , , , 090.5, 090.6, 090.7, 090.9, 091.0, 091.1, 091.2, 091.3, 091.4, , , , , , 091.7, , , , 091.9, 092.0, 092.9, 093.0, 093.1, , , , , , , , , 093.9, 094.0, 094.1, 094.2, 094.3, , , , , , , , , 094.9, 095.0, 095.1, 095.2, 095.4, 095.5, 095.6, 095.7, 095.8, 095.9, 096, 097.0, 097.1, 097.9, 098.0, , , , , , , , , , 098.2, , , , , , , , , , , , , , , , , , , , 098.6, 098.7, , , , , , , , 099.0, 099.1, 099.2, 099.3, , , , , , , , , , , , 099.8, 099.9, , , , , , 131.8, 131.9, 286.0, 286.1, 286.2, 286.3, 286.4, , , , 286.6, 286.7, 286.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.8, 556.9, 585.3, 585.4, 585.5, 585.6, 608.4, 614.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 760.2, V01.6, V01.79, V02.7, V02.8, V07.39, V07.39, V08, V12.3, V15.85, V42.0, V42.1, V42.2, V42.3, V42.4, V42.5, V42.6, V42.81, V42.82, V42.83, V42.84, V42.89, V42.9, V45.11, V56.0, V56.31, V56.32, V56.8, V58.2, V59.01, V59.02, V59.09, V59.1, V59.2, V59.3, V59.4, V59.5, V59.6, V59.8, V59.9, V65.44, V69.2, V70.0, V71.5, V73.89, V73.99, V74.5, V75.9, V83.01, V83.02, V , 86701, 86702, 86703, G0432, G0433, G0435, S3645, 36415, Diagnosis Code(s): V02.9, V70.0, V73.89, V74.5, V75.9, OR Pregnancy (see list at end of section). Pregnant females. No age or frequency Immunizations Administration: 90460, 90461, 90471, 90472, 90473, 90474, G0008, G0009, G0010 Hepatitis A: 90632, 90633, 90634, 90636; Hemophilus influenza b: 90645, 90646, 90647, 90648; HPV: 90649, ; Influenza virus: 90654, 90655, 90656, 90657, 90658, 90660, 90661, 90662, 90664, 90666, 90667, 90668, 90672,90673, 90685, 90686, 90688, Q2034, Q2035, Q2036, Q2037, Q2038, Q2039; Effective June 1, 2014 p. 4 of 9 Preventive benefits are applied to immunizations that are within the ages listed (if any) in the FDA

5 Major Depressive Disorder in Children and Adolescents () Pneumococcal conjugate: 90669, 90670, S0195; Rotavirus: 90680, 90681; Dtap / Dtpap-IPV, Dtap-Hib-IPV / DTP / DT / Tetanus / Polio / TdaP/ Measles, Mumps, Rubella / MMR: 90696, 90698, 90700, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90713, 90714, 90715, 90719, 90720, 90721, 90723; Varicella: 90716; Pneumococcal: 90732; Meningococcal: 90733, 90734, 90644; Zoster: 90736; Hepatitis B: 90740, 90743, 90744, 90746, 90747, Revenue Code: , G0444 Diagnosis Code(s): V79.0 (Required for only) Also see section below: for Depression in Adults approval, or, ACIP recommendations. See the Preventive Care Services Coverage Determination Guideline for details. Metabolic Panel S3620, 82017, 82136, 82261, 82775, 83020, 83498, 83516, 84030, 84437, 84443, 36415, Age 0 90 days. Newborn s Hearing : V5008, 92551, 92558, Hypothyroidism : 84437, 84443, 36415, Phenylketonuria : S3620, 84030, 36415, Sickle Cell : S3850, 83020, 83021, 83030, 83033, 83051, 36415, Osteoporosis 76977, 77078, 77080, 77081, G0130 Diagnosis Code(s): V17.81, V70.0, V82.81 Prevention of Dental Caries in Preschool Children (Counseling) Primary Care Interventions to Promote Breastfeeding This service is included in the payment for a Preventive Care visit. This service is included in primary care or OB/GYN office visits. Also see Expanded Women s Preventive Care table below. Age 0 90 days. Prevention of Falls in Community-Dwelling Older Adults This service is included in the payment for a Preventive Care visit or focused E&M visit. Prostate Cancer Code Group 1: G0102, G0103, 36415, Code Group 2 (requires diagnosis code): 84152, 84153, 84154, 36415, Diagnosis Code(s): Code Group 1: Code Group 2: V16.42, V70.0, V76.44 Males, age 40 and up. Effective June 1, 2014 p. 5 of 9

6 RH Incompatibility 86901, 36415, Diagnosis Code(s): Pregnancy (see list at end of section). Pregnant females. Rubella By History of Vaccination or by Serology and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse for Depression in Adults History of Vaccination: No codes (included in exam) Serology: 86762, 36415, Diagnosis Code(s): V70.0 or V , 99409, G0442, G , G0444 Diagnosis Code(s): V79.0 (Required for only) Also see section above: Major Depressive Disorder in Children and Adolescents () for High Blood Pressure for Intimate Partner Violence This service is included in a preventive care wellness examination or focused E&M visit. This service is included in a preventive care wellness exam. for Obesity in Adults for Obesity in Children and Adolescents for Visual Impairment in Children 97802, 97803, 97804, 99401, 99402, 99403, 99404, G0446, G0447 Diagnosis Code(s) (Required for and ): BMI 30+ and Obesity: V85.30 V85.39, V85.41 V85.45, , , 97803, 97804, 99401, 99402, 99403, 99404, G0446, G0447 Diagnosis Code(s) (Required for and ): Obesity: , , Children less than age 5. Mammography G0202, 77052, 77057; Revenue code: 0403 Syphilis 86592, 86593, 36415, Diagnosis Code(s): V70.0, V74.5, V74.9, V75.9 OR Pregnancy (see list at end of section). Wellness Examinations (well baby, well child, well adult) G0402, G0438, G0439, G0445, S0610, S0612, S0613, , , , , Effective June 1, 2014 p. 6 of 9

7 Bright Futures: Anemia in Children Developmental/Autism Dyslipidemia Hearing Tests Lead TB Testing Cancer s: 85014, 85018, 36415, Diagnosis Code(s): V20.2, V20.31, V20.32, V Diagnosis Code(s): V , 82465, 83718, 83719, 83721, 84478, 36415, Diagnosis Code(s): V20.2, V , 92552, Diagnosis Code(s): V20.2, V , 36415, Diagnosis Code(s): V20.2, V , Diagnosis Code(s): , , V20.2. V74.1 CPT code is only payable as preventive with diagnosis code , or V74.1 Ages 24 months to 21 years. * The following is a list of preventive cancer screenings. These are also listed above. Cervical Cancer, Pap Smear Colorectal Cancer Code Group 1 (payable regardless of diagnosis code): G0101, G0123, G0124, G0141, G0143 G0145, G0147, G0148, Q0091, P3000, P3001 Code Group 2 (requires a diagnosis code from list below): , 88147, 88148, 88150, , , 88174, Diagnosis Code(s) Code Group 2: V70.0, V72.31, V72.32, V76.2 Fecal Occult Blood Testing, Sigmoidoscopy, or Colonoscopy: Code Group 1 (Preventive regardless of diagnosis code): G0104, G0105, G0106, G0120, G0121, G0122, G0328 Code Group 2 (Preventive if billed in addition to a Code Group 1 code, OR if billed with one of the Diagnosis codes below): Procedure Codes: 44388, 44389, 44392, 44393, 44394, 45330, 45331, 45333, 45338, 45339, 45378, 45380, 45381, 45383, 45384, 45385, 82270, Diagnosis Code(s) (for Code Group 2): V16.0, V18.51, V18.59, V70.0, V76.41, V76.50, V76.51 Code Group 3 (Pathology): 88304, (These are Preventive if billed with one of the listed diagnosis code from Code Group 2 PLUS one of the Procedure code from Code Group 1 or 2). Computed Tomographic Colonography (Virtual Colonoscopy) (Preventive regardless of diagnosis code): limits. Effective June 1, 2014 p. 7 of 9

8 Prostate Cancer Mammography Code Group 1: G0102, G0103, 36415, Code Group 2: (requires diagnosis code): 84152, 84153, 84154, 36415, Diagnosis Code(s): Code Group 1: Code Group 2: V16.42, V70.0, V76.44 G0202, 77052, 77057; Revenue code: 0403 Males, age 40 and up. Pregnancy Diagnosis Code List: The following codes are required only where indicated in the Preventive Care Services table (above), or in the Expanded Women s Preventive Care Services table (below): V22.0 V22.2 V23.0 V23.3, V23.41, V23.42, V23.49, V23.5, V23.7, V23.81 V23.86, V23.87, V23.89, V23.9 V91.00 V91.03, V91.09, V91.10 V91.12, V91.19 V91.22, V91.29, V91.90 V91.92, V91.99 Expanded Women s The following benefits are effective beginning the first plan year on or after 8/1/12. Code(s): Well-Woman Visits Also see Wellness Well-woman visits: See the Wellness Examinations section above. Examinations section Prenatal Office Visits: ; ; 99078, G0463 in the Preventive Care Prenatal Care Visits: 59425, Services table above. Global Obstetrical Codes*: 59400, 59510, 59610, * The routine, low-risk, prenatal visits portion of the Global Obstetrical code is covered as preventive. Diagnosis Code(s): See Pregnancy Diagnosis Code list above. for Gestational Diabetes 82947, 82948, 82950, 82951, 82952, 83036, 36415, Diagnosis Code(s): See Pregnancy Diagnosis Code list above. Pregnant females. Human Papillomavirus DNA Testing Counseling for Sexually Transmitted Infections Counseling and for Human Immune-deficiency Virus Contraceptive Methods (Including Diagnosis Code(s): V70.0, V72.31, V73.81, or V76.2 See the Wellness Examinations section of the Preventive Care Services table above. Counseling: See the Wellness Examinations section of the Preventive Care Services table above. Tests: See the HIV Human Immunodeficiency Virus for Adolescents and Adults section of the Preventive Services table above. Code Group 1: 58565, 58600, 58605, 58611, 58615, 58670, 58671, A4264, 57170, A4261, A4266, J7300, J7301 Effective June 1, 2014 p. 8 of 9 Females age 30 +

9 Expanded Women s The following benefits are effective beginning the first plan year on or after 8/1/12. Code(s): Sterilizations) NOTE: Certain health plans may qualify for an exemption from covering contraceptive methods and sterilizations. Breastfeeding Support, Supplies, and Counseling and Counseling for Interpersonal and Domestic Violence Code Group 2: (requires a diagnosis from list below): 11976, 11981, 11982, 11983, 58300, 58301, J1050, J7302, J7306, J7307, S4981, S4989 Code Group 2a: (Preventive when billed with J1050 AND one of the Code Group 2 Diagnosis Codes below): Code Group 2 Diagnosis Code(s): V25.01, V25.02, V25.03, V25.09, V25.11, V25.12, V25.13, V25.40, V25.41, V25.42, V25.43, V25.49, V25.5, V25.8, V25.9 Code Group 3: (requires diagnosis V25.2): 00851, 00940, 00942, 00950, 00952, 01960, 01961, 01965, 01966, 01967, Code Group 3 Diagnosis Code: V25.2 Code Group 4: (Tubal ligation followup hysterosalpingogram): 58340, Code Group 4 Diagnosis Code: V26.51 Support and Counseling: S9443, , , (Also see the codes in the Wellness Examinations section of the Preventive Care Services table above.) Diagnosis Code(s): V24.1 (Code V24.1 is required for , , and ) Equipment & Supplies: (Purchase of a personal-use electric breast pump) E0603, A4281, A4282, A4283, A4284, A4285, A4286 Diagnosis Code(s): Pregnancy diagnosis (see list above) or V24.1 See the Wellness Examinations section of the Preventive Care Services table above. Diagnosis Code(s): See the Wellness Examinations section of the Preventive Care Services table above. One pump per birth. N/A Effective June 1, 2014 p. 9 of 9

Preventive Care Services Health Care Reform The following benefits are effective beginning the first plan year on or after Sept.

Preventive Care Services Health Care Reform The following benefits are effective beginning the first plan year on or after Sept. Coding Summary for Providers NOTE THE FOLLOWING: The purpose of this document is to provide a quick reference of the applicable codes for UnitedHealthcare plans that cover preventive care services in accordance

More information

Procedure: 76700, 76705, 76770, 76775, G0389. Diagnosis: V15.82 Procedure: 80061, 82465, 83718, 83719, 83721, 84478 36415, 36416

Procedure: 76700, 76705, 76770, 76775, G0389. Diagnosis: V15.82 Procedure: 80061, 82465, 83718, 83719, 83721, 84478 36415, 36416 Page 1 of 12 2013 Confluence Health & Affiliated Providers Health Plan Preventive Medicine List Service Codes Notes Screening Services Abdominal Aortic Aneurysm Screening One time screening for men ages

More information

PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION

PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION Health Plan of Nevada and Sierra Health and Life suggest that health plan members get certain screening tests, exams and shots to stay healthy. This document

More information

Health Care Reform: Using preventive care for a healthier life

Health Care Reform: Using preventive care for a healthier life HorizonBlue.com Health Care Reform: Using preventive care for a healthier life Horizon Blue Cross Blue Shield of New Jersey is committed to empowering our members with access to preventive services to

More information

Preventive Care Coverage Wondering what preventive care your plan covers?

Preventive Care Coverage Wondering what preventive care your plan covers? STAYING WELL Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue

More information

Preventive Care Coverage Wondering what preventive care your plan covers?

Preventive Care Coverage Wondering what preventive care your plan covers? STAYING WELL Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association Preventive Care Coverage Wondering what preventive care your plan covers? Our

More information

Preventive Services at 100%

Preventive Services at 100% September 1, 2014 Update Preventive Care Services Covered Without Cost-sharing Without Copay, Coinsurance or Deductible The Affordable Care Act (ACA) requires non-grandfathered health plans and policies

More information

Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women

Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Annual screening for pregnant women Bacteriuria For pregnant women at 12-16 weeks gestation or first prenatal visit

More information

Health care reform update

Health care reform update Preventive services coverage Kaiser Foundation Health Plan of the Northwest has always offered broad, affordable coverage options that encourage members to seek care before a health condition becomes serious.

More information

A PROVIDER S GUIDE TO PREVENTIVE HEALTH SERVICES FOR YOUR PATIENTS (COMMERCIAL PLANS ONLY)

A PROVIDER S GUIDE TO PREVENTIVE HEALTH SERVICES FOR YOUR PATIENTS (COMMERCIAL PLANS ONLY) ConnectiCare updated its preventive health services coverage to comply with the federal health reform law. Under this law, new health plans beginning on or after September 23, 2010, will provide certain

More information

Understanding your coverage. Preventive health care guidelines

Understanding your coverage. Preventive health care guidelines Understanding your coverage Preventive health care guidelines Preventive services are immunizations, screenings, lab tests and other services that either help prevent illness or help find diseases or medical

More information

ACA Mandates First Dollar Coverage for Preventive Services

ACA Mandates First Dollar Coverage for Preventive Services I N F O R M A T I O N U P D A T E May 2013 ACA Mandates First Dollar Coverage for Preventive Services The Affordable Care Act (ACA) mandates that, effective for Plan Years beginning on or after Sept. 23,

More information

Get a better understanding of your coverage

Get a better understanding of your coverage HealthReform From the Blues Office of National Health Reform The Michigan Blues: Trusted resources Health care reform under the Patient Protection and Affordable Care Act is changing the way health care

More information

Coverage for preventive care

Coverage for preventive care Coverage for preventive care Understanding your preventive care coverage Preventive care, like screenings and immunizations, helps you and your family stay healthier and can help lower your overall out-of-pocket

More information

Prevents future health problems. You receive these services without having any specific symptoms.

Prevents future health problems. You receive these services without having any specific symptoms. Preventive Care To help you live the healthiest life possible, we offer free preventive services for most Network Health members. Please refer to your member materials, which you received when you enrolled

More information

EmblemHealth Preventive Care/Screening Services Table:

EmblemHealth Preventive Care/Screening Services Table: EmblemHealth Preventive Care/ Services Table: Important Notes ACA-mandated preventive care/screening services are exempt from cost-sharing ONLY when performed within the health plan network. Coverage is

More information

2015 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest.

2015 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest. 2015 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. Guidelines may change throughout the year based on new research and recommendations. Get the most up-to-date

More information

PREVENTIVE CARE SERVICES Detailed descriptions

PREVENTIVE CARE SERVICES Detailed descriptions PREVENTIVE CARE SERVICES Detailed descriptions How often and what kind of preventive care services you need depends upon your age, gender, health and family history. Not all items on this list are covered

More information

Preventive care services for commercial members

Preventive care services for commercial members Preventive care services for commercial members This schedule is a reference tool for planning your preventive care and lists items/services covered under the Patient Protection and Affordable Care Act

More information

HEALTH CARE REFORM. Preventive Care. BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina

HEALTH CARE REFORM. Preventive Care. BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina HEALTH CARE REFORM Preventive Care BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina Preventive Care There was a time when an apple a day was the best preventive care advice

More information

2016 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest PREVENTIVE HEALTH CARE GUIDELINES 1

2016 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest PREVENTIVE HEALTH CARE GUIDELINES 1 2016 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. 2016 PREVENTIVE HEALTH CARE GUIDELINES 1 Priority Health is committed to improving the health and lives of you

More information

Understanding preventive care

Understanding preventive care Understanding preventive care We want you to be your healthiest. That s why the preventive services listed here are free for most members. What services are recommended? Know before you go. Preventive

More information

Coding Guidelines for Preventive Care Services Commercial (Non-Medicare) Group Health Plans

Coding Guidelines for Preventive Care Services Commercial (Non-Medicare) Group Health Plans Coding Guidelines for Preventive Care Services Commercial (Non-Medicare) Group Health Plans EXPLANATION: In accordance with the Patient Protection and Affordable Care Act (commonly referred to as federal

More information

IN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services)

IN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services) HMO-OA-CNT-30-45-500-500D-13 HMO Open Access Contract Year Plan Benefit Summary This is a brief summary of benefits. Refer to your Membership Agreement for complete details on benefits, conditions, limitations

More information

Preventive Care Guidelines

Preventive Care Guidelines Preventive Care Guidelines In accordance with Health Care Reform, for In-Network Providers, Non-Grandfathered Plans must provide benefits for and prohibit the imposition of cost-sharing requirements (including

More information

USPSTF Grade A B Recommendations

USPSTF Grade A B Recommendations USPSTF Grade Recommendations bdominal aortic aneurysm screening: men The USPSTF recommends one-time screening for abdominal aortic aneurysm by ultrasonography in men aged 65 to 75 who have ever smoked.

More information

Preventive Health Services

Preventive Health Services understanding Preventive Health Services For the most current version of this document, visit www.wellwithbluemt.com or www.bcbsmt.com. Preventive health services include evidence-based screenings, immunizations,

More information

PREVENTIVE CARE SERVICES

PREVENTIVE CARE SERVICES COVERAGE DETERMINATION GUIDELINE Guideline Number: CDG.016.08 Effective Date: September 1, 2015 PREVENTIVE CARE SERVICES Table of Contents COVERAGE RATIONALE... DEFINITIONS APPLICABLE CODES... REFERENCES...

More information

Preventive health guidelines As of May 2015

Preventive health guidelines As of May 2015 Preventive health guidelines As of May 2015 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Employer Sponsored Minimum Essential Coverage (MEC)

Employer Sponsored Minimum Essential Coverage (MEC) P.O. Box 129 Fort Mill, SC 29716 1-877-851-0906 SAMPLE EMPLOYEE SR 123 STREET RD Date: 05/01/2014 ANY, WI 12345 Group Number: M0001023 Employer Sponsored Minimum Essential Coverage (MEC) Your employer

More information

PREVENTIVE CARE SERVICES

PREVENTIVE CARE SERVICES PREVENTIVE CARE SERVICES CLINICAL POLICY Policy Number: PREVENTIVE 006.35 T0 Effective Date: September 1, 2015 Table of Contents CONDITIONS OF COVERAGE... COVERAGE RATIONALE DEFINITIONS... APPLICABLE CODES...

More information

PREVENTIVE CARE SERVICES GUIDELINES

PREVENTIVE CARE SERVICES GUIDELINES PREVENTIVE CARE SERVICES GUIDELINES SHPO reimburses providers for s rendered below as preventive benefits with a $0.00 cost share to the member. If coded as indicated in the model, members pay $0.00 for

More information

KEYSOLUTIONTM. Minimum Essential Coverage (MEC) and Minimum Value Plans (MVP) ENROLLMENT GUIDE. Administered by Key Benefit Administrators, Inc.

KEYSOLUTIONTM. Minimum Essential Coverage (MEC) and Minimum Value Plans (MVP) ENROLLMENT GUIDE. Administered by Key Benefit Administrators, Inc. KEYSOLUTIONTM ENROLLMENT GUIDE Minimum Essential Coverage (MEC) and Minimum Value Plans (MVP) Administered by Key Benefit Administrators, Inc. PLAN DESIGNED FOR THE EMPLOYEES OF Minimum Essential Coverage

More information

Preventive health guidelines As of May 2014

Preventive health guidelines As of May 2014 To learn more about your plan, please see anthem.com/ca. To learn more about vaccines, please see the Centers for Disease Control and Prevention (CDC) website: cdc.gov. Preventive health guidelines As

More information

Preventive Care Services

Preventive Care Services Preventive Care Services Accompanies Non-Grandfathered Health Plans What kinds of preventive and wellness services are covered for you and your family at no out-of-pocket cost? As part of the Patient Protection

More information

Blue represents coding updates. 6/30/12 cancel 99408

Blue represents coding updates. 6/30/12 cancel 99408 An Independent Licensee of the Blue Cross and Blue Shield Association Preventive Care Services The following is a list of preventive services (HCP rider) along with the diagnoses and procedure codes that

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2015 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Preventive Health Guidelines

Preventive Health Guidelines Preventive Health Guidelines As of April 2010 What is your plan for better health? Make this year your best year for overall wellness. Your health benefits plan may cover early detection screenings and

More information

Supplemental materials for:

Supplemental materials for: Supplemental materials for: Maciosek MV, LaFrance A, Dehmer SP, McGree D, Flottemesch TJ, Xu Z, Solberg LI. Updated priorities among effective clinical preventive services. Ann Fam Med. 2017;15(1):14-22.

More information

Important health care reform notice Women s preventive services covered with no member cost share

Important health care reform notice Women s preventive services covered with no member cost share Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Important health care reform notice Women s preventive services covered with no member cost share www.aetna.com

More information

Take advantage of preventive care to help manage your health

Take advantage of preventive care to help manage your health Take advantage of preventive care to help manage your health Preventing disease and detecting health issues at an early stage, if they occur, are important to living a healthy life. Following these recommended

More information

Preventive care covered with no cost sharing

Preventive care covered with no cost sharing Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Preventive care covered with no cost sharing Get checkups, screenings, vaccines, prenatal care, contraceptives

More information

A B. C Plan C: It s Time to Choose Your 2015 Health Benefits. Plan A

A B. C Plan C: It s Time to Choose Your 2015 Health Benefits. Plan A HABLAMOS ESPANOL! Open Enrollment ends March 27. It s Time to Choose Your 2015 Health Benefits choose one... A B Plan A Wellness + Preventive $7.83 / week Plan B Plan A + Hospital Indemnity + Sickness,

More information

Logic Staffing. Medical Plan Options and Enrollment Information. Enrollment Guide. Administered by Key Benefit Administrators, Inc.

Logic Staffing. Medical Plan Options and Enrollment Information. Enrollment Guide. Administered by Key Benefit Administrators, Inc. Enrollment Guide Medical Plan Options and Enrollment Information Administered by Key Benefit Administrators, Inc. PLANS DESIGNED FOR THE EMPLOYEES OF Logic Staffing Minimum Essential Coverage (MEC) Minimum

More information

CIGNA S PREVENTIVE HEALTH COVERAGE

CIGNA S PREVENTIVE HEALTH COVERAGE A guide to CIGNA S PREVENTIVE HEALTH COVERAGE for health care professionals Introduction Cigna s preventive care coverage complies with the Patient Protection and Affordable Care Act (PPACA). Services

More information

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening Preventive Care Schedule Effective January 1, 2016 Highmark Blue Cross Blue Shield Express Scripts The plan pays for preventive care only when given by a network provider. Use your Highmark BCBS ID card

More information

CIGNA S PREVENTIVE HEALTH COVERAGE for health care professionals

CIGNA S PREVENTIVE HEALTH COVERAGE for health care professionals A guide to CIGNA S PREVENTIVE HEALTH COVERAGE for health care professionals Introduction Cigna s preventive care coverage complies with the Patient Protection and Affordable Care Act (PPACA). Services

More information

This notice provides a safe harbor for preventive care benefits allowed to. be provided by a high deductible health plan (HDHP) without satisfying the

This notice provides a safe harbor for preventive care benefits allowed to. be provided by a high deductible health plan (HDHP) without satisfying the Part III - Administrative, Procedural, and Miscellaneous Notice 2004-23 PURPOSE This notice provides a safe harbor for preventive care benefits allowed to be provided by a high deductible health plan (HDHP)

More information

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening Preventive Care Schedule Effective January 1, 2016 Highmark Blue Cross Blue Shield Express Scripts The plan pays for preventive care only when given by a network provider. Certain vaccines are available

More information

Aetna Life Insurance Company

Aetna Life Insurance Company Aetna Life Insurance Company Hartford, Connecticut 06156 Amendment Policyholder: Group Policy No.: Effective Date: UNIVERSITY OF PENNSYLVANIA POSTDOCTORAL INSURANCE PLAN GP-861472 This Amendment is effective

More information

CIGNA S PREVENTIVE HEALTH COVERAGE for Health Care Professionals

CIGNA S PREVENTIVE HEALTH COVERAGE for Health Care Professionals A Guide to CIGNA S PREVENTIVE HEALTH COVERAGE for Health Care Professionals Introduction Cigna s preventive care coverage complies with the Patient Protection and Affordable Care Act (PPACA). Services

More information

A GUIDE TO CIGNA S PREVENTIVE HEALTH COVERAGE

A GUIDE TO CIGNA S PREVENTIVE HEALTH COVERAGE A GUIDE TO CIGNA S PREVENTIVE HEALTH COVERAGE For health care professionals Introduction Cigna s preventive care coverage complies with the Patient Protection and Affordable Care Act (PPACA). Services

More information

R e c o m m e n d e d Sc r e e n i n g s, T e s t s, a n d Im m u n i z a t i o n s f o r

R e c o m m e n d e d Sc r e e n i n g s, T e s t s, a n d Im m u n i z a t i o n s f o r Does your family history include? High blood pressure High cholesterol Heart disease, heart disease before age 50 in a male relative or before age 60 in a female relative, or heart attack Diabetes Breast

More information

Employees. Coverage. Choices. you deserve. you demand. Viva UAB Access 2016

Employees. Coverage. Choices. you deserve. you demand. Viva UAB Access 2016 2016 For Employees Coverage you deserve. Choices you demand. Access to all participating Viva Health Providers No referrals required to see specialists Viva UAB Access 2016 Effective Dates: January 1,

More information

Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64

Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64 Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64 1. BMI - Documented in patients medical record on an annual basis. Screen for obesity and offer intensive counseling and behavioral

More information

Health Maintenance Guidelines for Women

Health Maintenance Guidelines for Women Health Maintenance Guidelines for Women Customize your plan: These guidelines apply to healthy women in the general population. The right plan for your care may differ based on your medical history, family

More information

2015 External Employee Benefits

2015 External Employee Benefits 2015 External Employee Benefits Corporate Office 9995 N. Gate Parkway Suite 100 Jacksonville, FL 32246 (904) 338-9515 Fax (904) 338-9520 Nashville Office 3000 Meridian Blvd., Bldg. A Suite 160 Franklin,

More information

Be Healthy. Be Healthy. Using Your Wellness Benefits. Helping You Stay Healthy. Wellness Benefits

Be Healthy. Be Healthy. Using Your Wellness Benefits. Helping You Stay Healthy. Wellness Benefits Be Healthy Wellness Benefits Be Healthy Using Your Wellness Benefits Helping You Stay Healthy Health Alliance emphasizes prevention through comprehensive wellness coverage. We support members throughout

More information

2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide

2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide 2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide HEDIS Measure: Test/Care Needed for Compliance Adult BMI Assessment Individuals ages 18-74 Documentation of BMI and

More information

Routine Preventive Services. Covered by Medicare 2012

Routine Preventive Services. Covered by Medicare 2012 Routine Preventive Services Covered by Medicare 2012 Brook Golshan, CPC, ACS-EM 2/20/2012 1 Preventive Services Covered by Medicare 2012 Covered by Medicare Part B: Original/Direct Medicare Most of the

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

BROKER GUIDE TO HEALTH CARE REFORM

BROKER GUIDE TO HEALTH CARE REFORM for groups 2 50 for groups of 51+ individual & family plans BROKER GUIDE TO HEALTH CARE REFORM January 2011 Inside: Understanding grandfathered status Benefit rule changes Preventive services summary Key

More information

Coverage Overview. Preventive Care. For complete details, please call Aetna at 1-800-423-9752.

Coverage Overview. Preventive Care. For complete details, please call Aetna at 1-800-423-9752. Coverage Overview The following charts highlight our most commonly used services under the Progressive medical plans administered by Aetna. Please be aware that certain covered services are subject to

More information

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP SCREENING EXAMINATION & COUNSELING UPMC Health Plan Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Annually Physical Exam and Counseling 1 Blood Pressure 2 At each visit. At least

More information

Illinois Insurance Facts Illinois Department of Insurance

Illinois Insurance Facts Illinois Department of Insurance Illinois Insurance Facts Illinois Department of Insurance Women s Health Care Issues Revised August 2012 Note: This information was developed to provide consumers with general information and guidance

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

the power of prevention

the power of prevention the power of prevention Put our preventive health guidelines into practice. Your family s health could depend on it. You ve heard the old saying about an ounce of prevention. Your doctors know that preventive

More information

WHAT GRANDFATHERED PLANS DO AND DON'T HAVE TO COVER. Judy Pfriemer, Chair, Employee Benefits jpfriem@astate4.edu HEALTH INSURANCE 2016???

WHAT GRANDFATHERED PLANS DO AND DON'T HAVE TO COVER. Judy Pfriemer, Chair, Employee Benefits jpfriem@astate4.edu HEALTH INSURANCE 2016??? Judy Pfriemer, Chair, Employee Benefits jpfriem@astate4.edu HEALTH INSURANCE 2016??? WHAT GRANDFATHERED PLANS DO AND DON'T HAVE TO COVER All health plans must End lifetime limits on coverage End arbitrary

More information

Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1

Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1 Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1 Prevention 2.01 Cervical Cancer Screening (CIHI Derived from indicator # 50) Percentage of female enrolled patients 21 to

More information

UnitedHealthcare s Approach to Women s Preventive Care Services

UnitedHealthcare s Approach to Women s Preventive Care Services Preventive Care Services Overview Coverage for expanded women s preventive care services was effective as of the health plan s first renewal date on or after Aug. 1, 2012. UnitedHealthcare s Approach to

More information

99381, 99382: Initial preventive medicine evaluation 99391, 99392: Periodic preventive medicine re-evaluation

99381, 99382: Initial preventive medicine evaluation 99391, 99392: Periodic preventive medicine re-evaluation Age Birth - 24 months 2-11 s M/ M/ Preventive medicine, re-, or office visit/ 8 visits within the first 24 months of life (As part of preventive medicine or re-, Hemoglobin, hematocrit, or CBC for those

More information

the power of prevention

the power of prevention the power of prevention Put our preventive health guidelines into practice. Your family s health could depend on it. You ve heard the old saying about an ounce of prevention. Your doctors know that preventive

More information

Included: Sample tweets/facebook posts Twitter Chat materials (sample questions/answers) Well- Woman Visit Infographic Social media images (posts,

Included: Sample tweets/facebook posts Twitter Chat materials (sample questions/answers) Well- Woman Visit Infographic Social media images (posts, Included: Sample tweets/facebook posts Twitter Chat materials (sample questions/answers) Well- Woman Visit Infographic Social media images (posts, cover photo, Twitter chat promo) National Women s Health

More information

Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over

Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over 1. BMI - Documented in patients medical record on an annual basis up to age 74. Screen for obesity and offer counseling to encourage

More information

Hawaii Benchmarks Benefits under the Affordable Care Act (ACA)

Hawaii Benchmarks Benefits under the Affordable Care Act (ACA) Hawaii Benchmarks Benefits under the Affordable Care Act (ACA) 10/2012 Coverage for Newborn and Foster Children Coverage Outside the Provider Network Adult Routine Physical Exams Well-Baby and Well-Child

More information

AETNA BETTER HEALTH OF MISSOURI

AETNA BETTER HEALTH OF MISSOURI Aetna Better Health of Missouri 10 South Broadway, Suite 1200 St. Louis, MO 63102 800-566-6444 AETNA BETTER HEALTH OF MISSOURI HEDIS Quick Reference Billing Guide 2014 Diagnosis and/or procedure codes

More information

HEALTHCARE REFORM PREVENTIVE MEDICATIONS LIST NO COST-SHARE PREVENTIVE MEDICATIONS

HEALTHCARE REFORM PREVENTIVE MEDICATIONS LIST NO COST-SHARE PREVENTIVE MEDICATIONS The Patient Protection and Affordable Care Act (PPACA), also know as HealthCare Reform, includes coverage for preventive health care services and certain medication with no out-of-pocket. The Department

More information

Wellness guidelines for all ages

Wellness guidelines for all ages Wellness guidelines for all ages Live healthy, stay safe A message about your health Thank you for choosing Independence Blue Cross(IBC). Your health and wellness are important. That's why we provide you

More information

Women s Preventative Health

Women s Preventative Health Women s Preventative Health Routine Screening and Recommendations Mary Claire Haver, MD Assistant Professor Associate Residency Director Department of Obstetrics and Gynecology University of Texas Medical

More information

Preventive Care Recommendations THE BASIC FACTS

Preventive Care Recommendations THE BASIC FACTS Preventive Care Recommendations THE BASIC FACTS MULTIPLE SCLEROSIS Carlos Healey, diagnosed in 2001 The Three Most Common Eye Disorders in Multiple Sclerosis Blood Pressure & Pulse Height & Weight Complete

More information

Questions & Answers on ACA Section 4106 Improving Access to Preventive Services for Eligible Adults in Medicaid

Questions & Answers on ACA Section 4106 Improving Access to Preventive Services for Eligible Adults in Medicaid Questions & Answers on ACA Section 4106 Improving Access to Preventive Services for Eligible Adults in Medicaid STATE PLAN AMENDMENT (SPA) Q1. Can a state submit a SPA to implement section 4106 at any

More information

Preventive Health Guide. Smart Steps Toward Better Health

Preventive Health Guide. Smart Steps Toward Better Health Preventive Health Guide Smart Steps Toward Better Health Plan to: Get regular health exams + Keep immunizations current Maintain a healthy weight Use health tools on bcbst.com Protect Your Health with

More information

Doctor visits and exams

Doctor visits and exams UnitedHealthcare Community Plan wants you to take care of yourself. While the guidelines in this section apply to most women, you should discuss them with your doctor because you may need more - or less

More information

Carnegie Mellon University Policy #02424 Benefits at a Glance Effective Date: January 1, 2014

Carnegie Mellon University Policy #02424 Benefits at a Glance Effective Date: January 1, 2014 Carnegie Mellon University is offering Medical, Dental, Vision, Pharmacy, Medical Evacuation and Repatriation benefits through Cigna Global Health Benefits to our employees. This comprehensive international

More information

COVERAGE SCHEDULE. The following symbols are used to identify Maximum Benefit Levels, Limitations, and Exclusions:

COVERAGE SCHEDULE. The following symbols are used to identify Maximum Benefit Levels, Limitations, and Exclusions: Exhibit D-3 HMO 1000 Coverage Schedule ROCKY MOUNTAIN HEALTH PLANS GOOD HEALTH HMO $1000 DEDUCTIBLE / 75 PLAN EVIDENCE OF COVERAGE LARGE GROUP Underwritten by Rocky Mountain Health Maintenance Organization,

More information

Wellness Exam Coverage Highlights

Wellness Exam Coverage Highlights The following Medicare Advantage plans have updated coding procedures for 2013: AARP MedicareComplete UnitedHealthcare MedicareComplete UnitedHealthcare Dual Complete UnitedHealthcare MedicareDirect Wellness

More information

Deductibles Type Value Network Out-of-Network Benefit. Individual $1,000 per covered person per contract year. Not Applicable

Deductibles Type Value Network Out-of-Network Benefit. Individual $1,000 per covered person per contract year. Not Applicable Consumers Mutual Value Network - Premier Schedule of Benefits Deductibles Type Value Network Out-of-Network Benefit Individual $1,000 per covered person per contract year. Not Applicable Family $2,000

More information

Your Guide to Medicare s Preventive Services

Your Guide to Medicare s Preventive Services Your Guide to Medicare s Preventive Services C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S This is the official government booklet with important information about: What disease

More information

One time screening, repeat screening for those at risk

One time screening, repeat screening for those at risk 2015 Adult Male Preventive Health Guidelines Important Note Health Net s Preventive Health Guidelines provide Health Net members and practitioners with recommendations for preventive care services for

More information

IHS Clinical Reporting System

IHS Clinical Reporting System RESOURCE AND PATIENT MANAGEMENT SYSTEM IHS Clinical Reporting System (BGP) Version 12.1 Office of Information Technology (OIT) Division of Information Resource Management Albuquerque, New Mexico Revision

More information

IS HERE OPEN ENROLLMENT EMPLOYEE BENEFITS TIME TO MAKE YOUR BENEFIT CHOICES. BAYADA Home Health Care Employee Benefits

IS HERE OPEN ENROLLMENT EMPLOYEE BENEFITS TIME TO MAKE YOUR BENEFIT CHOICES. BAYADA Home Health Care Employee Benefits 2015 OPEN ENROLLMENT IS HERE EMPLOYEE BENEFITS TIME TO MAKE YOUR BENEFIT CHOICES BAYADA Home Health Care values the contributions of our employees. In appreciation of your dedicated service, BAYADA Home

More information

Women with Medicare. Visiting Your Doctor for a Pap Test, Pelvic Exam, and Clinical Breast Exam

Women with Medicare. Visiting Your Doctor for a Pap Test, Pelvic Exam, and Clinical Breast Exam CENTERS FOR MEDICARE & MEDICAID SERVICES Women with Medicare Visiting Your Doctor for a Pap Test, Pelvic Exam, and Clinical Breast Exam This official government booklet will help you understand what s

More information

HEDIS Code Quick Reference Guide Preventive/Ambulatory Services

HEDIS Code Quick Reference Guide Preventive/Ambulatory Services HEDIS Code Quick Reference Guide Preventive/Ambulatory Services Child/Adolescent Care Well-Child Visits in the First 15 Months of Life [Commercial, Medicaid] Well-Child Visits in the Third, Fourth, Fifth

More information

MEDICARE PREVENTIVE PHYSICAL EXAM

MEDICARE PREVENTIVE PHYSICAL EXAM MEDICARE PREVENTIVE PHYSICAL EXAM l Initial Preventive Physical Exam (Welcome to Medicare Physical) l Initial annual wellness visit l Subsequent annual wellness visit l Other Patient name Medical record

More information

Organize Your Family's Health Care with this Checklist of Routine Physical Exams and

Organize Your Family's Health Care with this Checklist of Routine Physical Exams and All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to: Screen for diseases Assess risk of future medical problems Encourage a

More information

AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE

AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE Plan Name: AZ Gold HMO 25/50/500 AZN1010010116071 AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE This Certificate of Coverage ("Certificate") is part of the Group Agreement ("Group Agreement") between

More information

2014 Coding Procedures Update for Medicare Advantage

2014 Coding Procedures Update for Medicare Advantage 2014 Coding Procedures Update for Medicare Advantage The following Medicare Advantage plans have updated coding procedures for 2014: AARP MedicareComplete UnitedHealthcare MedicareComplete UnitedHealthcare

More information

Immunization Information for Blinn College Students

Immunization Information for Blinn College Students 1 Immunization Information for Blinn College Students *Important Information Regarding the Bacterial Meningitis Vaccine* The State passed Senate Bill 1107 in 2011 and recently Senate Bill 62 in 2013, which

More information

AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE

AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE AETNA HEALTH INC. (Arizona) CERTIFICATE OF COVERAGE Plan Name: AZ Silver HNOption 1500 70/50 AZO0010010116071 This Certificate of Coverage ("Certificate") is part of the Group Agreement ("Group Agreement")

More information

Series of 2 doses, 6-12 months apart. One dose is 720 Elu/0.5ml (GSK) or 25 u/0.5 ml (Merck)

Series of 2 doses, 6-12 months apart. One dose is 720 Elu/0.5ml (GSK) or 25 u/0.5 ml (Merck) UTAH PREVENTIVE CARE RECOMMENDATIONS Adult - Ages 19 and Above IMMUNIZATIONS CONTENTS: General Instructions Hepatitis A Hepatitis B Human Papilloma Virus Influenza Meningococcal A, C, Y, W (MCV4) Meningococcal

More information