Cardiology Coding Alert

If you have a physician who qualifies, watch for 3 key coverage requirements.

On Nov. 8, CMS announced it will cover an annual cardiovascular disease prevention visit for all beneficiaries.

"Access to preventive services helps Medicare beneficiaries identify health risk factors and disease early to provide greater opportunities for early treatment," said CMS administrator Donald Berwick, MD, in a Nov. 8 statement.

Snag: Before you get too excited, take note that CMS is restricting the preventive visit mainly to non-specialists. "The visit must be furnished by primary care practitioners, such as a beneficiary's family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians' offices," CMS said in its Nov. 8 email about the coverage. The Decision Memorandum itself also adds geriatric medicine practitioners and ob-gyns to the list of specialties eligible to perform the benefit.

If your practice includes those who qualify as primary care practitioners, be sure to read the Decision Memo in its entirety at www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=248.

The Decision Memo provides valuable information, such as that CMS will cover the free intensive cardiovascular risk reduction visit, which includes the following three components:

Encouraging aspirin use for preventing cardiovascular disease "when the benefits outweigh the risks for men age 45-79 years and women 55-79 years"

Screening for high blood pressure in adults age 18 years and older

Intensive behavioral counseling to promote a healthy diet in patients with hyperlipidemia, hypertension, advancing age, and other risk factors for cardiovascular and diet-related chronic disease issues.