# 5 A's form



## Cottrell (Dec 21, 2011)

The new Cardiovascular screen and the new Alcohol Screening services state that "the counseling services must be consistent with the 5As approach that has been adopted by the USPSTF to describe such services". It goes onto list the 5 A's. 

I am looking for any kind of template/form that might be out there that has the 5A's listed to ensure they are all captured.

I have been researching this all day and I am unable to find anything out there. USPSTF website doesn't have anything either.

Does any one know of where I would be able to find a form I could tweak??
I am trying to not reinvent the wheel if I don't have to.

FYI-This is also going to be needed for the new Obesity screenings when they are allowed to be billed.


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## Pam Brooks (Dec 22, 2011)

Check Medicare Claims Processing Manual, 100-4, Chapter 18, section 180.1 for the ETOH screening information.  The five A's are:
1. Assess
2. Advise
3. Agree
4. Assist
5. Arrange

These are discussed in detail.  I have seen no specific template, but you can devise one based on these items and the expectations outlined.

The attachment to this chapter, Transmittal 2358 also discusses this information.  

There's a MedLearn Matters article for CVD.  The 5 A's are the same, just related to CVD.  Look at MM7636.

Hope this helps.  Pam


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## Cottrell (Dec 22, 2011)

Thanks Pam. Looks like I am off to invent the wheel on this one.

Thanks again.


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## Cheryl Duff (Jan 3, 2012)

*New MC screening codes*

Hi,
Since these new MC screening codes (G0442, G0443, G0444)  are based on time (15 minutes) does anyone know if the provider must spend at least 15 minutes with the patient or would it be appropriate to use the same timing elements that are used for time-based PT codes {1 unit: ≥ 8 minutes through 22 minutes, etc}  ?  I haven't been able to find any info on this.
Thanks,
Cheryl


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