Calm Down! Don’t Have a Stroke!

Heeding this phrase probably never actually prevented a stroke, but 80% of all strokes can be prevented.  The National Stroke Association however is capitalizing on Stroke Awareness Month this May to provide real ways to prevent a stroke.  They are also offering a wealth of information on how to recognize when a stroke is occurring.  If you suspect a stroke, you should always dial 911.

stroke symptoms

Stroke Risk falls into two categories: controllable and uncontrollable.  Health care providers are crucial in the management of the controllable risk factors of their patients.  So much so, CMS has added coverage for many preventive services that are directly related to these risk factors.  As part of the ACA, commercial payers are also covering many preventive services.  Below you will find basic information on five of the controllable risk factors and applicable billing codes, etc.

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Controllable Risk Factors:

alcohol counselingAlcohol – consumption levels should be discussed as part of annual physical or other visits to identify potential misuse.  Recommended daily limits are: women 1 drink /men 2 drinks.

                Billing for alcohol misuse:

HCPCS Code       Code Descriptor

G0442                   Annual alcohol misuse screening, 15 minutes

G0443                   Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes


blood pressure screeningCholesterol and High Blood Pressure – should be checked at least annually as part of a routine physical. 

                Billing for Cardiovascular Disease (CVD) Screening Blood Tests:

HCPCS Code       Code Descriptor

80061                    Lipid panel, this panel must include the following:

82465                    Cholesterol, serum, total

83718                    Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol)

84478                    Triglycerides


If abnormal results are found:

                Billing Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD):

HCPCS Code       Code Descriptor

G0446                   Annual, face-to-face IBT for CVD, individual, 15 minutes


diabetes testing Diabetes – assessment for risk factors for diabetes should be performed as well as routine care for known diabetic patients.

                Billing for Diabetes Screening:

HCPCS Code       Code Descriptor

82947                    Glucose; quantitative, blood (except reagent strip)

82950                    Glucose; postglucose dose (includes glucose)

82951                    Glucose; tolerance test (GTT), 3 specimens (includes glucose)


Billing for Diabetes Self-Management Training (DSMT):

HCPCS Code       Code Descriptor

G0108                   DSMT, individual, per30 minutes

G0109                   DSMT, group (2 or more), per 30 minutes


obesity and BMIObesity– in adults the Body Mass Index (BMI) is calculated by dividing weight in kilograms by the square of height in meters (expressed kg/m2). For patients identified with aBMI of 30.0 and over:

                                Billing Intensive Behavioral Therapy (IBT) for Obesity:

HCPCS Code       Code Descriptor

G0447                   Face-to-Face Behavioral Counseling for Obesity, 15 minutes


smoking cessation counselingSmoking – Tobacco use should be discussed as part of annul physical or other visits.  Smoking doubles the risk of stroke.

Billing for smoking cessation:

HCPCS Code       Code Descriptor

G0436                   Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes

G0437                   Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes

99406                    Smoking and tobacco-use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes

99407                    Smoking and tobacco-use cessation counseling visit; intensive, greater than 10 minutes


 primary care physician 

Primary healthcare providers play a major role in stroke prevention.  They work together with their patients helping them to follow a healthy lifestyle that includes exercise, proper nutrition, and recommended medical care.