Alcohol Misuse Screening and Counseling CPT G0442 and G0443

HCPCS/CPT Codes

• G0442 – Annual alcohol misuse screening, 15 minutes
• G0443 – Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes

Who Is Covered

 

All Medicare beneficiaries are eligible for alcohol screening.

 

Medicare beneficiaries who screen positive (those who misuse alcohol but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence) are eligible for counseling if,

• They are competent and alert at the time counseling is provided and
• Counseling is furnished by qualified primary care physicians or other primary care practitioners in a primary care setting

Covered ICD Codes

• F10.282 Alcohol dependence with alcohol-induced sleep disorder
• F10.288 Alcohol dependence with other alcohol-induced disorder
• F10.29 Alcohol dependence with unspecified alcohol-induced disorder
• F10.920 Alcohol use, unspecified with intoxication, uncomplicated
• F10.921 Alcohol use, unspecified with intoxication delirium
• F10.929 Alcohol use, unspecified with intoxication, unspecified
• F10.94 Alcohol use, unspecified with alcohol-induced mood disorder
• F10.950 Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
• F10.951 Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
• F10.959 Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
• F10.96 Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
• F10.97 Alcohol use, unspecified with alcohol-induced persisting dementia
• F10.980 Alcohol use, unspecified with alcohol-induced anxiety disorder
• F10.981 Alcohol use, unspecified with alcohol-induced sexual dysfunction
• F10.982 Alcohol use, unspecified with alcohol-induced sleep disorder
• F10.988 Alcohol use, unspecified with other alcohol-induced disorder
• F10.99 Alcohol use, unspecified with unspecified alcohol-induced disorder
• F12.23 Cannabis dependence with withdrawal
• F12.93 Cannabis use, unspecified with withdrawal
• O99.310 Alcohol use complicating pregnancy, unspecified trimester
• O99.311 Alcohol use complicating pregnancy, first trimester
• O99.312 Alcohol use complicating pregnancy, second trimester
• O99.313 Alcohol use complicating pregnancy, third trimester
• O99.314 Alcohol use complicating childbirth
• O99.315 Alcohol use complicating the puerperium
• R45.88 Nonsuicidal self-harm
• T51.8X2A Toxic effect of other alcohols, intentional self-harm, initial encounter
• T51.8X3A Toxic effect of other alcohols, assault, initial encounter
• T51.8X4A Toxic effect of other alcohols, undetermined, initial encounter
• T51.92XA Toxic effect of unspecified alcohol, intentional self-harm, initial encounter
• T51.93XA Toxic effect of unspecified alcohol, assault, initial encounter
• T51.94XA Toxic effect of unspecified alcohol, undetermined, initial encounter
• Z02.83 Encounter for blood-alcohol and blood-drug test
• Z13.30 Encounter for screening examination for mental health and behavioral disorders, unspecified
• Z13.31 Encounter for screening for depression
• Z13.32 Encounter for screening for maternal depression
• Z13.39 Encounter for screening examination for other mental health and behavioral disorders
• Z63.72 Alcoholism and drug addiction in family
• Z71.41 Alcohol abuse counseling and surveillance of alcoholic
• Z71.42 Counseling for family member of alcoholic
• Z71.84 Encounter for health counseling related to travel
• Z81.1 Family history of alcohol abuse and dependence

Frequency

• Annually for G0442
• For those who screen positive, 4 times per year for G0443

Medicare Beneficiary Pays

• Copayment/coinsurance waived
• Deductible waived