Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Coding)
Preventive services
required under the
PPACA (continued)
11-16
Effective for plan years beginning on or after August 1, 2012,
PPACA requires certain items and services covered without cost–
sharing for women as recommended by the:
United States Preventive Services Task Force (USPSTF) ratings
of A or B
Advisory Committee of Immunization Practices (ACIP), under
the Centers for Disease Control and Prevention (CDC)
Health Resources and Services Administration (HRSA)
Guidelines for Preventive Care and Screenings for Women,
Infants, Children and Adolescents
To the extent not described in the USPSTF recommendations,
HRSA was charged with developing comprehensive guidelines for
preventive care and screenings for women. As part of this process,
HRSA commissioned an Institute of Medicine (IOM) report
entitled: “Clinical Preventive Services for Women: Closing the
Gaps”
1. Well–woman visit
2. Screening for gestational diabetes mellitus (GDM)
3. Counseling for sexually transmitted infection (STI)
4. Counseling and screening for human hmmunodeficiency virus
(HIV)
5. Counseling and screening for interpersonal and domestic
violence
6. Breastfeeding support, supplies and counseling
7. Human papillomavirus (HPV) testing
8. Contraceptive methods and counseling *
* Some employer group plans may be exempt or in temporary safe
harbor status for “contraceptive methods and counseling” and will
not have to offer women’s preventive “contraceptive methods and
counseling” until their plan year beginning on or after August 1,
2013. Temporary safe harbor does not apply to individual policies.
Non-preventive care received during a preventive care visit is
subject to normal plan cost sharing.
Please see the chart below for more information on the additional
services, recommendations and suggested coding.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)