HCPCS Code G0403: Electrocardiogram (ECG) Performed as a Screening for the IPPE (with Interpretation and Report)

Code G0403 is not is a HCPCS code for a routine 12-lead electrocardiogram (ECG) performed as a screening during the Initial Preventive Physical Examination (IPPE) for new Medicare beneficiaries. It includes the ECG test along with interpretation and report of the results.

Yes, G0402 (initial preventive physical exam visit) and G0403 (screening ECG with interpretation and report during the IPPE) can be billed together on the same date of service but must be distinct services. G0402 bills the preventive physical examination IPPE itself, while G0403 bills the routine ECG with 12 leads done as part of that exam.

G0438 is the code for the initial annual wellness visit (AWV), typically done once after the first 12 months of Medicare enrollment. G0439 is used for all subsequent annual wellness visits after the initial AWV. The initial AWV (G0438) has a higher reimbursement and involves establishing a baseline personalized prevention plan, while G0439 updates that plan.

G0439 can be billed once every 12 months after the initial AWV (G0438) or the last G0439 visit. It is not time-based by minutes or hours but strictly limited to one billed service per beneficiary each year, usually with a 12-month spacing requirement.