Wiki AWV (Seen Earlier) - What to do?

ccat78

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Hello all - If a patient was scheduled (and seen) for an AWV but was seen earlier than the 12 months timeframe, is there another way to re-billed this visit for coverage? Thank you.
 
From a coding standpoint, you code the service that was provided. Coding may change based on a carrier's specific guideline. Coding may not change in attempt to have an insurance pay for something that is not covered.
If the visit was an AWV and also a follow up for HTN, DM, etc., then you may bill the E/M portion of the visit to insurance.
If this was truly only an AWV, there is no compliant way to bill this and have it covered.
Learn from this and educate your staff.
 
From a coding standpoint, you code the service that was provided. Coding may change based on a carrier's specific guideline. Coding may not change in attempt to have an insurance pay for something that is not covered.
If the visit was an AWV and also a follow up for HTN, DM, etc., then you may bill the E/M portion of the visit to insurance.
If this was truly only an AWV, there is no compliant way to bill this and have it covered.
Learn from this and educate your staff.
Thank you for this clarification. Much appreciated.
 
Hello all - If a patient was scheduled (and seen) for an AWV but was seen earlier than the 12 months timeframe, is there another way to re-billed this visit for coverage? Thank you.
I agree with the above comment. We code on documentation. If it truly was an AWV the. Code that, if anything new was address then you can potentially pull out a separate E/M. At that point it would fall on billing yo send for a write off most likely.
 
I agree with the above comment. We code on documentation. If it truly was an AWV the. Code that, if anything new was address then you can potentially pull out a separate E/M. At that point it would fall on billing yo send for a write off most likely.
Thank you for your comment on this as well! I appreciate it.
 
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