2025 HCPCS code G0403
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Electrocardiogram Preventive Services Feed
Screening electrocardiogram (ECG) with 12 leads, including tracing, interpretation, and report, performed as part of the Initial Preventive Physical Examination (IPPE).
Modifiers may be applicable depending on the circumstances of service.Consult the CMS guidelines for appropriate modifier usage.
The ECG is medically necessary as part of the comprehensive assessment during the IPPE to screen for cardiovascular disease in Medicare beneficiaries.
The physician or qualified non-physician practitioner is responsible for performing the ECG, interpreting the results, and generating a report.
In simple words: This code covers a heart test (ECG or EKG) that's part of a routine checkup for new Medicare patients.The doctor uses many sensors to check the heart's electrical activity, reviews the results, and gives a report to explain what the test showed.
This HCPCS code represents a routine electrocardiogram (ECG) performed as a screening for the Initial Preventive Physical Examination (IPPE).The procedure involves obtaining a 12-lead ECG tracing, interpreting the results, and generating a report. This is a comprehensive test assessing the heart's electrical activity to identify potential abnormalities. The provider attaches 12 electrodes to the patient's chest, arms, and legs to record the heart's electrical signals, which are then interpreted to detect any heart muscle weakness or irregular heartbeat. The interpretation and report are integral parts of this code.
Example 1: A 68-year-old male newly enrolled in Medicare undergoes an IPPE, which includes a 12-lead ECG as part of the comprehensive assessment., A 72-year-old female with a history of hypertension presents for her IPPE.The ECG is performed to evaluate for any underlying cardiac abnormalities., A 75-year-old male with newly diagnosed diabetes undergoes an IPPE.The 12-lead ECG is done to screen for potential cardiac complications associated with diabetes.
* Documentation of the IPPE visit.*A complete 12-lead ECG tracing.* Physician's interpretation and report of the ECG findings.* Medical record indicating the patient is receiving their initial preventive physical examination.
** This code is specifically for the ECG portion of the Initial Preventive Physical Examination (IPPE) and should not be used for other ECG services.
- RVU: Information not available in provided text. Consult CMS or other relevant resources for RVU data.
- Global Days: Not applicable. This is a diagnostic test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable to this code.
- Fee Schedule: Information not available in the provided text. Consult CMS or other relevant resources for historical fee schedule data.
- Specialties:Cardiology, Internal Medicine, Family Medicine
- Place of Service:Office, Clinic