Annual Wellness Visits: G0438-G0439: Find Out What the MACs Are Saying About the New AWV Codes

Why This Topic Matters

The piece helps readers identify whether they need to investigate AWV claim denials, coordinate billing with same-day services, or review timing rules tied to Medicare contractor processing. It is especially useful for practices submitting Medicare Part B claims during the initial rollout of the annual wellness visit benefit.

Article Sections

1. Introductory overview

   The opening sets up the rollout of the annual wellness visit benefit and the early claims-processing issues reported by practices and Medicare contractors.

2. Question 1: Which Diagnosis Code Should We Use?

   This section addresses early denial reports tied to diagnosis coding for annual wellness visit claims and notes payer communications about reprocessing.

3. Question 2: Can We Bill An E/M With the AWV?

   This section discusses Medicare contractor guidance on reporting a separate evaluation and management service on the same date as an annual wellness visit and mentions the associated billing elements at a broad level.

4. Question 3: Is It Necessary to Let 365 Days Pass Between A Patient's Annual Wellness Visits?

   This section covers payer guidance on the interval between annual wellness visits and the general timing interpretation referenced by Medicare contractors.