Welcome to Medicare

Pt came in for Welcome to Medicare. Doc did an EKG on a pt at the same time. Is ECG (G0403 or G0405) and EKG the same? I know we can bill this with the IPPE. Thanks!

re: Welcome to Medicare

A patient who has just qualified for Medicare Part B is allowed this once in a lifetime benefit within the first 12 months of Medicare eligibility. Medicare calls this exam the Initial Preventative Physical Exam or IPPE but it is more widely known as the “Welcome to Medicare Visit - Medicare no longer deems the screening EKG as a mandatory service component of the IPPE. However, there is a once in a lifetime screening EKG that is allowed as a result of a referral from an IPPE and must be performed at the time of the IPPE. The screening EKG and IPPE must both be completed before they can be billed to Medicare and the beneficiary will be responsible for any copayment, coinsurance or deductible that is assessed by Medicare. -
G0403 Complete screening EKG with 12 leads; for IPPE that includes the tracing, interpretation and report (copayment/coinsurance/deductible applies)
• G0404 Screening EKG with 12 leads; tracing only without interpretation and report (copayment/coinsurance/deductible applies)
• G0405 Screening EKG with 12 leads; interpretation and report only, without tracing