# IPPE exams with new requlations for 2009



## pamike (Dec 8, 2008)

Has anyone found any information regarding what is required for documentation to support the "end of life planning" for the IPPE exams beginning in 2009, and what kind of documentation of "consent for discussion of end of life planning?

Pam


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## efrohna (Dec 8, 2008)

Pam, I bolded your answer below.  Your facility probably has an "Advanced Directive" form that could be filled out, _*if the patient consents to it*_.
Good luck.

H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008
Changes to the "Welcome to Medicare" Physical Exam

Since 2005, new Medicare Part B enrollees have been entitled to an Initial Preventive Physical Examination (IPPE) within six months of enrollment. The IPPE includes measurement of the patient's height, weight, blood pressure, review of the medical and social history, the individual's risk factors for depression, functional ability and level of safety with the goal of health promotion and disease detection.

On July 15, 2008, H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008 became law. The law extends the time for the IPPE to one year following Part B enrollment. The HCPCS code to use when submitting for IPPE reimbursement for the “once in a lifetime benefit per beneficiary” is G0344. 

*There is language included in the law that requires physicians, nurse practitioners and physician assistants to inform patients about end-of-life planning as part of the IPPE.  It states that the term “end of life planning” means: 1) verbal or written information regarding an individual's ability to prepare an advance directive in the case that an injury or illness causes the individual to be unable to make health care decisions; and,
2) whether or not the physician is willing to follow the individual's wishes as expressed in an advance directive.*
As patients age into Medicare coverage, an opportunity is provided for
physician/patient discussion of future healthcare treatment for a time when patients may not be able to speak for themselves.

More information on H.R. 6331 can be found at:
http://www.ama-assn.org/ama1/pub/upload/mm/399/hr6331_highlights.pdf
http://www.bcbsaforms.org/downloads/Bill_Summary_-_HR_6331_-_MIPPA_07-09-08.pdf  For information on the Welcome to Medicare Physical Examination, go to http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0711.pdf
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5235.pdf


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## SHobbs (Apr 2, 2013)

I am a little bit confused on what is actually required for the end of life planning.  Do the providers just need documentation if the patient has an advance directive in place and if so if the provider agrees to follow this?  If not, do they determine the patients ability to develop their living will discuss this with the patient?  Do our providers actually fill this out with them?


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