Medicare Covers STDs Screening

Sexually Transmitted Diseases (STDs) are no longer conditions that are only discussed in back alley clinics.  Proof is based on the fact that statistics show that STDs are commonly affecting those as young as 15 and Medicare now covers STD preventive services.  A diverse range of clinicians from Pediatrics to Geriatric Medicine are being called upon to help reduce STD’s in our communities.  

Not all diseases are preventable, but in the case of STDs, awareness is the key to prevention as emphasized this month by Centers for Disease Control (CDC).  As always awareness goes hand in hand with education.  As the key sponsor of Sexually Transmitted Disease Awareness for the month of April, the CDC is offering a wide range of information for both the public and healthcare professionals alike.  

Many people would be shocked to read these STD statistics:

Approximately 20 million new STD’s are diagnosed each year

Half of all new STD’s are attributed to people age 15-24

Annual cost of treating STD’s is almost $16 billion

Even though there have been noted disparities in the occurrence of STDs in certain populations, there is no race, sex, economic status or age group that is exempt.  It is of the utmost importance that healthcare professionals take advantage of each opportunity to have an open and frank discussion with all of their patients regarding these highly preventable conditions.   

These discussions should include these basics:

Inquiries about high risk behavior 

Ways to prevent contracting a disease

The signs and symptoms associated with common STDs

As mentioned earlier in this article, as of November 8, 2011, CMS made Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) part of its panel of covered preventive services. 

 The tables below highlight coverage information that can be found at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/PreventiveServices.html

 

 

Covered Screening Service for Increased Risk Patients	HCPCS/CPT Codes	ICD-9 Codes	Patient Financial Responsibility
Chlamydia	86631, 86632, 87110, 87270, 87320, 87490, 87491, 87810	Non-pregnant female:V74.5 & V69.8 Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9	Deductible and coinsurance waived
Gonorrhea	87590, 97591, 87850	Non-pregnant female:V74.5 & V69.8 Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9	Deductible and coinsurance waived
Combined Chlamydia and Gonorrhea	87800	Non-pregnant female:V74.5 & V69.8 Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9	Deductible and coinsurance waived
Syphilis	86592, 86593, 86780	Non-pregnant female:V74.5 & V69.8 Pregnant female:V74.5 & V22.0, V22.1 or V23.9 Male: V74.5 & V69.8	Deductible and coinsurance waived
Hepatitis B	87340, 87341	Pregnant female: V73.89 & V69.8 & V22.0, V22.1, or V23.9	Deductible and coinsurance waived

Covered Counseling Service for Increased Risk Patients	HCPCS/CPT Codes	Frequency	Patient Financial Responsibility
High Intensity Behavioral Counseling	G0445	Up to two HIBC counseling sessions annually	Deductible and coinsurance waived