Providers can now bill and get paid for hepatitis C screening using the new code G0472 for dates of service on or after June 2, 2014. Tests can be performed on high – risk patients defined as anyone with a current or past history of illicit drug use or anyone who received a blood transfusion before 1992. These patients are eligible for one screening per year. Patients who continue to use illicit drugs will be covered for additional screenings after the initial screening is negative. In addition, patients born between 1945 and 1965 also can be screened for one lifetime test.
The hepatitis C screening can be ordered by any of the below. Claims from any other provider types will be denied.
- General practice
- Family practice
- Internal medicine
- Obstetrics/gynecology
- Pediatric medicine
- Geriatric medicine
- Certified nurse midwife
- Nurse practitioner
- Certified clinical nurse specialist
- Physician assistant
Bill G0472 with diagnosis code V69.8 – other problems related to lifestyle – for high–risk patients during their initial screening. If a high–risk patient needs additional screening due to continue drug use, bill V69.8 and add 304.91 – unspecified drug dependence, continuous.