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Initial Health Assessment (IHA) Coding Updates

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IHA Code Changes

The Initial Health Assessment (IHA) will apply coding updates to better capture services being rendered to our members. The coding updates include changes to the ICD-10 and CPT codes, impacting the Provider Portal Reports and Care-Based Incentive (CBI) program. These updates are effective immediately.

  • ICD10 removal: Z00.9, Z02.3
  • CPT removals: Hospital Codes- 99222-99223
  • ICD10 additions
    • Z00.8- Encounter for other general examination
    • Z02.9- Encounter for administrative examinations, unspecified

IHA Billing Codes

Member population CPT billing codes ICD-10 Reporting codes
Preventive visit, new patient 99381-99387 No restriction
Preventive visit, established patient 99391-99397 No restriction
Office visit, new patient 99204-99205 No restriction
Office visit, established patient 99215 CPT and appropriate diagnosis code: Z00.00, Z00.01, Z00.110, Z00.111, Z00.121, Z00.129, Z01.411, Z01.419, Z00.8, Z02.1, Z02.89, Z02.9
Prenatal care Z1032, Z1034, Z1038, Z6500 Pregnancy related diagnosis

For more information, please see the Initial Health Assessment section under Health Assessments on our website, or the Care-Based Incentive Resources for measure information.