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Wiki AWV

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aksilvis

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Nampa, ID
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I have a provider that tends to see pts for their AWV, ACP and often a seperate E/M code on the same visit. Lately I am being told that insurance will not cover the ACP 99497 portion of the visit. We are billing it with a 33 modifier (which is how we have always billed it) I am at a complete loss. I've researched everything I can think of. Is there anyone with any experience in this area that can help me out?
 
We bill a lot of AWV, ACP, and majority of the time also a separate E&M code level (with modifier 25) provided on the same day. We bill 99497-33 DX: Z71.89 as this is billable once per year. We are still getting reimbursed for these services as well.
 
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