annual exam

HBULLOCK

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I work in a Pedi office but we do have a few patients with Medicare. I was wondering if I should be using the E/M code (99395) or if i should be using the G code? There are so many rules specific to Medicare and where I don't code them enough I'm not sure. Anyone who bills these I would appreciate your help. They never paid the physicals before so if i can get paid using the G code I would like to do that. Thanks :)
 

rradeke

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Medicare will NOT pay a 99395 it is proper to use the G codes for Annual Wellness Exams and then physician will be reimbursed.
 

berger

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Of note the AWV is NOT a head to toe physical it is a time for MD to dicuss with patient Prevention.
 

Pam Brooks

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Of note the AWV is NOT a head to toe physical it is a time for MD to dicuss with patient Prevention.


That's correct--it's a risk assessment visit. Unfortunately, Medicare has called it and "examination" in some of their past patient information, and it caused a lot of confusion last year.
 

HBULLOCK

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Thanks for the response ladies. Our exam is not a risk assessment exam its the patients annual physical so to me that means I should continue to use the 99395 code. I will print off the Medicare B guidelines. Thanks again :)
 
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