Preventive Services: Hepatitis C Screening

HCPCS Codes

G0472 — 

Hepatitis C antibody screening, for individual at high risk and other covered indication(s)

G0567 — 

Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, screening, amplified probe technique

ICD-10 Codes

Z11.59, Z72.89, F19.20

Note: Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM codes on the CMS ICD-10 codes for National Coverage webpage. Find your MAC’s website for more information.

Medicare Covers

Adult patients with Medicare Part B who meet at least 1 of these criteria:

• Are at high risk for HCV infection
• Were born 1945–1965
• Had a blood transfusion before 1992

Frequency

• Once for patients born 1945–1965 not considered high-risk (use ICD-10 Z11.59)
• An initial patient screening, regardless of birth year, for high-risk patients (patients who had a blood transfusion before 1992 and patients with current or history of illicit injection drug use)
• Annually for high-risk patients with continued illicit injection drug use since the previous negative HCV screening test

Patient Pays

No copayment, coinsurance, or deductible