From the Guidelines
For Medicare Initial Preventive Physical Examination (IPPE) and screening tests, the following lab orders are recommended:
- Complete Blood Count (CBC) to assess overall health and detect any underlying conditions.
- Comprehensive Metabolic Panel (CMP) to evaluate kidney and liver function, as well as blood sugar and electrolyte levels.
- Lipid Profile to assess cholesterol and triglyceride levels.
- Fasting Blood Glucose (FBG) or Hemoglobin A1c (HbA1c) to screen for diabetes.
- Urinalysis to detect any urinary tract infections or kidney problems.
- Bone Mass Density (BMD) test for osteoporosis screening in individuals 65 and older, or younger individuals with risk factors.
- Colorectal Cancer Screening tests such as Fecal Occult Blood Test (FOBT), Flexible Sigmoidoscopy, or Colonoscopy, depending on individual risk factors and medical history, as recommended by the American College of Physicians 1.
- Mammography for breast cancer screening in women 40 and older, with annual screening recommended starting at age 40 1.
- Prostate-Specific Antigen (PSA) test and Digital Rectal Exam (DRE) for prostate cancer screening in men 50 and older, or younger individuals with risk factors, with the decision to screen made after discussing the benefits and limitations of testing with a healthcare provider 1.
These lab orders and screening tests are recommended to be performed at the following frequencies:
- IPPE: once in a lifetime, within the first 12 months of Medicare enrollment.
- Annual Wellness Visit (AWV): annually, starting 12 months after the IPPE.
- Colorectal Cancer Screening: every 10 years, or every 5 years for individuals with risk factors, as recommended by the American Cancer Society 1.
- Mammography: annually, or every other year, depending on individual risk factors and medical history.
- Prostate Cancer Screening: annually, or every other year, depending on individual risk factors and medical history, with the decision to screen made after discussing the benefits and limitations of testing with a healthcare provider 1.
From the Research
Laboratory Tests for Medicare Initial Preventive Physical Examination (IPPE)
The following laboratory tests are ordered for Medicare IPPE and screening tests:
- Mammography 2, 3
- Lipid panel 2
- Urinalysis 2
- Testing of blood glucose level 2
- Complete blood cell count 2
- Prostate cancer screenings 4
- Cholesterol screenings 4
- Flu vaccines 4
- Pap smears 4, 3
Screening Tests
Screening tests that are part of the Medicare IPPE include:
- Ultrasound screening exam 5
- Breast self-exams 4
- Prostate cancer screenings 4
- Cholesterol screenings 4
- Flu vaccines 4
- Pap smears 4, 3
- Mammograms 4, 3
Medicare Coverage
Medicare covers several cancer screening tests, including: