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February 14, 2018

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Medical Coding News Archives

Staying Current with Coverage Changes for HIV Screening

August 2, 2011:

Additional preventive services are covered when they meet statutory requirements set forth in the Medicare Improvements for Patients and Providers Act. One of those requirements is that the service have a grade A (strongly recommended) or grade B (recommended) rating by the U.S. Preventive Services Task Force (USPSTF). HIV screening has a grade A rating for all adolescents and adults at increased risk for HIV infection, as well as for all pregnant women.

Diagnosis coding for claims submitted for HIV screening have specific requirements, depending on whether the patient is pregnant and whether risk factors are reported. Claims are required to be submitted with one or more of the following diagnosis codes:

  • When increased risk factors are reported: V73.89 as primary and V69.8 as secondary
  • Increased risk factors are not reported: V73.89 as primary only
  • When the Medicare beneficiary is pregnant, submit one of the following diagnosis codes in addition to V73.89 to allow for the more frequent screening allowable under the benefit than once per 12-month period:
  • V22.0 Supervision of normal first pregnancy
    V22.1 Supervision of other normal pregnancy
    V23.9 Supervision of unspecified high-risk pregnancy


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