tci Part B Insider - 2016 Issue 16

Annual Wellness Visits: This MAC Reminds Practices to Use Caution Billing Separate E/M With AWV

Remember not to overlap history, exam when determining E/M level. When a patient presents for an annual wellness visit (AWV) or initial preventative physical exam (IPPE), you typically know how to report the visit. But if they have a separate issue that requires a deeper evaluation, that’s when coding can get tricky. One MAC tried to shed some light on this subject last week, and the key is to demonstrate the separate nature of the additional E/M service. Background: CMS covers an exam for a new Medicare patient called the IPPE (G0402), as well as an AWV(G0438-G0439) once...

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