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<strong>CMS</strong>-1403-FC<br />

applies to both adult men and women. End-of-life planning<br />

as previously described is verbal or written information<br />

given to the beneficiary regarding advance directive<br />

preparation and a discussion regarding whether the<br />

physician is willing to follow an individual’s wishes made<br />

in an advance directive.<br />

Therefore, for CY 2009, we are retaining the current<br />

work RVUs for the new IPPE G code (G0402) which involves<br />

equivalent resources and work intensity to those services<br />

contained in CPT evaluation and management (E/M) code<br />

99203, new patient, office or other outpatient visit.<br />

However, we are interested in receiving comments on<br />

suggested valuations of this service to reflect the<br />

resources required. We will also retain the work RVUs for<br />

the new EKG G codes which are equivalent to those for CPT<br />

codes 93000, 93005 and 93010. In addition, we note that<br />

the policy for reporting a medically necessary E/M service<br />

furnished at the same IPPE visit will still apply. CPT<br />

codes 99201 through 99215 may be used depending on the<br />

circumstances and appended with CPT modifier “25”<br />

identifying the E/M visit as a significant, separately<br />

identifiable service from the IPPE code G0402.<br />

We do not believe this scenario will be the typical<br />

occurrence and we will monitor utilization patterns<br />

813

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