Missouri WISEWOMAN Program Manual

The CDC’s NBCCEDP and WISEWOMAN programs have developed joint policies to provide guidance for an integrated office visit. The intent and benefit of coupling the two programs is to create a stronger link to ensure that as many women aged 40-64 who are enrolled in the NBCCEDP also receive appropriate CVD risk assessment and reduction in states that have both NBCCEDP and WISEWOMAN programs.

All office visits for WISEWOMAN screenings are expected to be integrated into the NBCCEDP screening office visit

Integrated Office Visits

Integrated office visits should occur for women aged 40-64 who are enrolled in the NBCCEDP. Both programs must appropriately reimburse for screening visits and services using the following guidance:

• NBCCEDP funds should be used to reimburse for the integrated office visit and WISEWOMAN funds should not be used to pay for these office visits unless they have received CDC approval to conduct non-integrated office visits
• WISEWOMAN funds should be used to reimburse providers for the costs associated with measuring cholesterol, lipids, glucose, A1C or any other applicable labs
• When rescreening for NBCCEDP and WISEWOMAN coincide, this should be an integrated office visit, with reimbursement for the office visit using NBCCEDP funds
• Any non-integrated rescreening or diagnostic office visits for WISEWOMAN services should be paid for with WISEWOMAN funds

WISEWOMAN Integrated Screening Services

The following WISEWOMAN clinical screening services are expected to be integrated into the NBCCEDP screening exam office visit:

• Two complete blood pressure measurements
• Height and weight measurement to calculate BMI
• Smoking assessment and referral for cessation (also expected as part of the NBCCEDP office visits)

Referral to WISEWOMAN

Women who are determined by their provider to be at risk for cardiovascular disease (e.g., elevated blood pressure, obesity, smoking, family history of cardiovascular disease, etc.) should be referred to WISEWOMAN for appropriate services. It is expected that state NBCCEDP and WISEWOMAN programs collaborate to develop procedures and policies to ensure needed services are received.

Risk Reduction Counseling

Women who are found to be at risk for cardiovascular disease (e.g., elevated blood pressure, obesity, tobacco use, family history of cardiovascular disease, etc.) should be referred for Risk Reduction Counseling through WISEWOMAN. Risk Reduction Counseling services can take place on the same day as the Screening Office Visit or on a different day, depending on the funded program structure, but must be billed appropriately. If women are referred for WISEWOMAN services on a different day, the programs must ensure that there is an adequate system in place for follow-up. Funded WISEWOMAN programs are expected to reimburse providers for the time spent conducting the Risk Reduction Counseling services. This reimbursement should be billed separate from the time spent conducting the clinical screening services that are part of the integrated office visit. The duration of the counseling should be appropriate to the level of counseling needed to convey the woman’s screening results, interpretation of the results and appropriate recommendations.

Follow-Up Services

Any needed follow-up services for NBCCEDP or WISEWOMAN should be scheduled, as appropriate. These services may occur simultaneously or consecutively depending upon the nature of care needed. Both programs must ensure that a system is in place to monitor the follow-up recommended.