Pennsylvania’s Hepatitis C Screening Act (ACT 87) was signed into law by Governor Tom Wolf on July 20th, 2016. It requires all baby boomers who receive inpatient or outpatient health services in a hospital, health care facility, or physician’s office to be offered a hepatitis C screening test regardless of risk factors or symptoms. People with hepatitis C can live for decades without symptoms, so many baby boomers remain unaware that they are living with an infection that can liver disease, liver failure, and/or cancer. All HEALTH INSURANCE PLANS ARE REQUIRED TO FULLY COVER THIS TEST FOR BABY BOOMERS, REGARDLESS OF THEIR CO-INSURANCE AND/OR DEDUCTIBLES.
While ACT 87 focuses on improving screening of baby boomers, all patients with risk factors-including drug use, tattoos received in an unlicensed setting, unprotected sex with someone who is hepatitis C positive, and blood or organ transplant before 1992-should also be offered the test as part of standard medical care.
CPT Code G0472 should be reported for this Hep C Screening Test, along with ICD 10 Code Z72.89, “other problems related to lifestyle.”