HIV Screening

2018

MEDICARE NATIONAL COVERAGE DETERMINATION (NCD) - 210.7

PROCEDURE CODE(S): G0432, G0433, G0435, G0475

PREVENTIVE SERVICES: Screening for the Human

Immunodeficiency Virus (HIV) Infection

56880

DLS TEST CODE AND NAME

HIV - 1/2 Ag/Ab WITH REFLEX

INDICATIONS / FREQUENCY

One (1) annual screening for male and female, when no increased risk factors are reported.

---------11 full months must elapse following the month in which the previous test was performed in order for the

subsequent test to be covered.

NOTE: Patients with any known prior diagnosis of HIV-related illness are not eligible for this screening test.

DESCRIPTION

ICD-10 CODE

Z11.4

Encounter for screening for human immunodeficiency virus [HIV]

INDICATIONS / FREQUENCY

Annual screening for male and female, when increased risk factors are reported.

---------11 full months must elapse following the month in which the previous test was performed in order for the

subsequent test to be covered.

NOTE: Patients with any known prior diagnosis of HIV-related illness are not eligible for this screening test.

DESCRIPTION

ICD-10 CODE

Z11.4

Encounter for screening for human immunodeficiency virus [HIV]

AND

Z72.51

Z72.52

Z72.53

Z72.89

High risk heterosexual behavior

High risk homosexual behavior

High risk bisexual behavior

Other problems related to lifestyle

INDICATIONS / FREQUENCY

Maximum of three (3) voluntary HIV screenings of pregnant Medicare beneficiaries: (1) when the diagnosis of

pregnancy is know, (2) during the third trimester, and (3) at labor, if ordered by the woman's clinician.

ICD-10 CODE

DESCRIPTION

Z11.4

Encounter for screening for human immunodeficiency virus [HIV]

AND

ONE OF THE SPECIFIED SUPERVISION OF PREGNANCY DIAGNOSIS CODE:

Z34.00

Encounter for supervision of normal first pregnancy, unspecified trimester

Z34.01

Encounter for supervision of normal first pregnancy, first trimester

Z34.02

Encounter for supervision of normal first pregnancy, second trimester

Z34.03

Encounter for supervision of normal first pregnancy, third trimester

Z34.80

Encounter for supervision of other normal pregnancy, unspecified trimester

Z34.81

Encounter for supervision of other normal pregnancy, first trimester

Z34.82

Encounter for supervision of other normal pregnancy, second trimester

Z34.83

Encounter for supervision of other normal pregnancy, third trimester

Z34.90

Encounter for supervision of normal pregnancy, unspecified, unspecified trimester

Z34.91

Encounter for supervision of normal pregnancy, unspecified, first trimester

Z34.92

Encounter for supervision of normal pregnancy, unspecified, second trimester

Z34.93

Encounter for supervision of normal pregnancy, unspecified, third trimester

O09.90

Supervision of high risk pregnancy, unspecified, unspecified trimester

O09.91

Supervision of high risk pregnancy, unspecified, first trimester

O09.92

Supervision of high risk pregnancy, unspecified, second trimester

O09.93

Supervision of high risk pregnancy, unspecified, third trimester

Source: cms.mcd

Prevent Svc - HIV Screening

Effective Date: 10-1-2015, last updated 4-1-2018

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