Medicare CPT coe G0442, G0443, covered ICD 10 AND frequency

Alcohol Misuse Screening and Counseling

Also referred to as the Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse


HCPCS/CPT Codes

G0442 – Annual alcohol misuse screening, 15 minutes
G0443 – Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes


ICD-10-CM Codes
See https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html for individual Change Requests (CRs) and coding translations for ICD-10


Who Is Covered
All Medicare beneficiaries are eligible for alcohol screening.

Medicare beneficiaries who screen positive (those who misuse alcohol but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence) are eligible for counseling if:

• They are competent and alert at the time that counseling is provided; and • Counseling is furnished by qualified primary care physicians or other primary care practitioners in a primary care setting.

Frequency
• Annually for G0442; or
• For those who screen positive, 4 times per year for G0443

Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived

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