I think my first question would be...why is the patient coming in? For the IPPE visit or to establish care. One doesn't always interchange with the other. As for the IPPE...The HCPCS code is G0402. I noticed you mentioned that the patient has been on Medicare for 6 mo. Effective for dates of service on or after January 1, 2009, Medicare provides coverage of the IPPE for all newly enrolled beneficiaries who receive the IPPE within the first 12 months after the effective date of their Medicare Part B coverage. It was previously within the first 6 months after their effective date with Medicare Part B. The IPPE has requirements that must be met in order for the IPPE to be covered. There is a quick reference grid that provides the required diagnosis codes for each component rendered. The link below provides some great information as well as some Q/A.
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