These seven components enable the Medicare provider to identify risk factors that may be associated with various diseases and to detect diseases early when outcomes are best. The provider is then able to educate and counsel the beneficiary about the identified risk factors and possible lifestyle changes that could have a positive impact on the beneficiary’s health. The IPPE includes all of the following services furnished to a beneficiary by a physician or other qualified non-physician practitioner:
Component 1 -- Review of the beneficiary’s medical and social history with attention to modifiable risk factors for disease detection
Medical history includes, at a minimum, past medical and surgical history, including experiences with illnesses, hospital stays, operations, allergies, injuries, and treatments; current medications and supplements, including calcium and vitamins; and family history, including a review of medical events in the beneficiary’s family, including diseases that may be hereditary or place the individual at risk.
Social history includes, at a minimum, history of alcohol, tobacco, and illicit drug use, diet, and physical activities.
Component 2 -- Review of the beneficiary’s potential (risk factors) for depression and othermood disorders
This includes current or past experiences with depression or other mood disorders, based on the use of an appropriate screening instrument for persons without a current diagnosis of depression. The physician or other qualified non-physician practitioner may select from various available standardized screening tests that are designed for this purpose and recognized by national professional medical organizations.
Component 3 -- Review of the beneficiary’s functional ability and level of safety
This is based on the use of appropriate screening questions or methods. The physician or other qualified
non-physician practitioner may select from various available screening questions or standardized questionnaires designed for this purpose and recognized by national professional medical organizations. This review must include, at a minimum, the following areas:
Activities of daily living
Component 4 -- A physical examination
This examination includes measurement of the beneficiary’s height, weight, and blood pressure; measurement of body mass index (required service effective January 1, 2009); a visual acuity screen; and other factors as deemed appropriate by the physician or qualified non-physician practitioner, based on the beneficiary’s medical and social history and current clinical standards.
Component 5 -- End-of-life planning
Effective for dates of service on or after January 1, 2009, the IPPE includes end-of-life planning as a required service, upon the beneficiary’s consent. End-of-life planning is verbal or written information provided to the beneficiary regarding:
The beneficiary’s ability to prepare an advance directive in the case that an injury or illness causes the beneficiary to be unable to make health care decisions, and
Whether or not the physician is willing to follow the beneficiary’s wishes as expressed in the
Component 6 -- Education, counseling, and referral based on the previous five components
Education, counseling, and referral, as determined appropriate by the physician or qualified non-physician practitioner, based on the results of the review and evaluation services described in the previous five components. Examples include the following:
Counseling on diet if the beneficiary is overweight
Education on prevention of chronic diseases
Referral for smoking and tobacco-use cessation counseling
Component 7 -- Education, counseling, and referral for other preventive services
Education, counseling, and referral, including a brief written plan, such as a checklist, provided to the individual for obtaining a screening EKG, if appropriate, and the appropriate screenings and other preventive services that are covered as separate Medicare Part B benefits, as listed below:
Bone mass measurements
Cardiovascular screening blood tests
Colorectal cancer screening tests
Diabetes screening tests
Diabetes outpatient self-management training services
Medical nutrition therapy for individuals with diabetes or renal disease
Pneumococcal, influenza, and hepatitis B vaccines and their administration
Prostate cancer screening tests
Screening for glaucoma
Screening Pap test and screening pelvic examinations
Ultrasound screening for abdominal aortic aneurysms
Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
CPT CODE and description 90460 - Immunization administration through 18 years of age via any route of administration, with counseling by ...
Flow Cytometry is a highly complex process by which blood, body fluids, bone marrow and tissue can be examined. It provides important immun...
CPT CODE and Description 97001 - Physical therapy evaluation Average fee payment $70 - $80 97002 - Physical therapy re-evaluation Ave...
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
CPT CODE and Description 90785 - Interactive complexity (List separately in addition to the code for primary procedure) 90791 - Psychi...
Here is the big list of Medical terminology abbreviation @—at A & P—anatomy and physiology ab—abortion abd—abdominal ABG—arterial ...
Place of Service: A two-digit code used on health care professional claims to indicate the setting in which a service was provided. Place...
Complete Blood Count (CBC) Testing A complete blood count consists of measuring a blood specimen for levels of hemoglobin, hematocrit, red...
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...