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June 3, 2021

Asian American and Pacific Islander Health Awareness

The Asian American and Pacific Islander community is one of the highest growing population groups in the United States. It is estimated that the AAPI (Asian American Pacific Islander) community accounted for 5.6% or 18.2 million of the US population. (Health Disparities Among Asian Americans and Pacific Islanders, 2020) The AAPI community is diverse with representation from over 30 countries and ethnic groups. Each of these smaller groups has its own unique health care needs. Several disease conditions found in the AAPI population include cancer (cervical and liver), mental health issues, hepatitis B, diabetes, and kidney disease.

Cancer is thought to be the leading cause of death among for Asian Americans and Pacific Islanders. The top two cancers for this population are cervical cancer and liver cancer. It is believed that one of the reasons for the higher rate of cervical cancer among AAPI women is the lower rate of screening for this cancer. As for liver cancer, Asian Americans and Pacific Islanders tend to have a higher rate of liver cancer as a result of hepatitis B infection and delayed screenings for cancer. For both types of cancer, early screening and treatment may contribute to better outcomes for these patients. Hepatitis B screening and immunizations can also assist with lowering the occurrence of liver cancer among these patients.

While not all AAPI are at higher risk for diabetes, certain subgroups of AAPI (Asian Americans, Native Hawaiians, and Pacific Islanders located in California and Hawaii) are at higher risk for diabetes. Many of these individuals do not know that they even have diabetes. Diabetes can lead to kidney failure for these individuals if they are not treated.

Mental illness is the unspoken condition in the AAPI community. Oftentimes, those in the AAPI community view discussing mental illness as a sign of weakness. Symptoms are displayed through physical symptoms rather than discussed. Asian American women ages 65-84 have the highest rate of suicide of all racial and ethnic groups. (NIMHD | The Center for Asian Health Engages Communities in Research to Reduce Asian American Health Disparities, n.d.)

Barriers to health care access for AAPI include but are not limited to challenges with communication due to language, lack of health insurance, differences in cultural beliefs and cultures, and lack of familiarity with the Western healthcare system. Increasing the public's awareness of the health issues Asian Americans and Pacific Islanders are facing and overcoming these barriers are imperative to improving the wellbeing of this community.

There are several steps you can take to promote the health of your Asian American and Pacific Islander beneficiaries. Encourage your patients to schedule annual wellness visits and health screenings. Evaluate your patients' mental well-being during medical visits. Educate patients on healthy habits such as exercising, and eating a well-balanced diet including foods that are low in salt, fat, and cholesterol. Talk to your patients about vaccinations and encourage them to schedule them if they are eligible.

Type of Service

HCPCS Code
CPT code

Notes

Link on CMS Medicare Preventive Services website

Depression Screening

HCPCS code G0444

  • Annually for all patient
  • Copayment/Coinsurance waived
  • Deductible waived

Depression ScreeningExternal website

Screening for Cervical Cancer

HCPCS code G0476

  • Every 5 years for all asymptomatic women
  • Copayment/Coinsurance waived
  • Deductible waived

Screening for Cervical Cancer with Human Papillomavirus (HPV) TestsExternal website

Screening Pelvic Examinations (includes a clinical breast examination)

Screening Pap tests

Screening Pelvic Exam
HCPCS code G0101

Screening Pap test
HCPCS codes G0123, G0124, G0141, G0143
G0144, G0145, G0147, G0148, P3000, Q0091

  • Annually for women at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap smear within past 3 years
  • Every 2 years (or 23 months past the month of last covered exam) for women at low risk
  • Copayment/Coinsurance waived
  • Deductible waived

Screening Pelvic Examinations (includes a clinical breast examination)External website

Screening Pap TestsExternal website

Hepatitis B Screening

HCPCS code G0499

CPT codes 86704
CPT code 86706
CPT code 87340
CPT code 87341

  • Review Medicare guidelines for criteria for beneficiary coverage
  • Specific frequency limitations for those at high and low risk
  • Copayment/Coinsurance waived
  • Deductible waived

Hepatitis B ScreeningExternal website

Hepatitis B Shot and Administration

CPT codes 90739, 90740, 90743, 90744, 90746, 90747

HCPCS code G0010

  • Medicare covers certain patients at immediate or high risk of contracting hepatitis .
  • Copayment/Coinsurance waived
  • Deductible waived

Hepatitis B Shot and AdministrationExternal website

Diabetes Screening

HCPCS code 82947
HCPCS code 82950
HCPCS code 82951

  • For patients with certain diabetes risk factors, Medicare covers one screening every 12 months (This benefit is for patients previously tested but not diagnosed with pre-diabetes or not previously tested.)
  • For patients diagnosed with pre-diabetes, Medicare covers one screening every six months.
  • Patients previously diagnosed with diabetes are not eligible for this benefit.
  • Copayment/Coinsurance waived
  • Deductible waived

Diabetes ScreeningExternal websiteExternal website

Medicare Diabetes Prevention Program

HCPCS codes G9873, G9874, G9875, G9876, G9877, G9878, G9879, G9880, G9881, G9882, G9883, G9884, G9885, G9890, G9891

  • Medicare will cover up to 24 sessions in a two-year period for those patients who meet following criteria:
    • Enrolled in Medicare Part B (or receiving Medicare benefits through a Medicare Advantage Part C plan)
    • BMI of at least 25 (or BMI of at least 23 if self identifies as Asian) by the first core session
    • Have one of the following results within 12 months prior to the 1st core session:

      Hemoglobin A1c level of 5.7-6.4%
      Fasting blood glucose level of 110-125 mg/dL
      Two-hour blood glucose test(oral glucose tolerance test) level of 140-199 mg/dL

    • No history of type 1 or 2 diabetes (gestational diabetes not included) prior to first core session
    • No diagnosis of End Stage Renal Disease (ESRD)
    • Have not previously received Medicare Diabetes Prevention Program (MDPP) services
  • Copayment/Coinsurance waived
  • Deductible waived

Medicare Diabetes Prevention ProgramExternal website

Visit the CMS Preventive Services websiteExternal website to learn more about other Medicare-covered services.

Resources:

References

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