tci Medicare Compliance & Reimbursement - 2016 Issue 10

Annual Wellness Visits: Get This Confusing Coding Scenario Clarified

he key is to demonstrate the separate nature of the additional E/M service, says Palmetto. If you find coding and billing for an encounter that combines an annual well visit (AWV) with a separate health issue challenging, then Part B MAC Palmetto Medicare has a useful tip for you. Background: The Centers for Medicare & Medicaid Services (CMS) covers an exam for a new Medicare patient called the initial preventative physical exam (IPPE) (G0402), as well as an AWV (G0438-G0439) once a year, but otherwise does not pay for preventive E/M services. Both the IPPE and AWV have very...

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