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 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 – 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
Cholesterol 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 – 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– 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 – 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 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.
