Difference between Medicare annual wellness visit and annual physical

[maryek28@outlook.com]

Can someone help me understand the difference between a regular annual physical (99381-99397) and the Medicare annual wellness (G0439)? Is the documentation supposed to be different for the Medicare one?

 

[natashalage]

I suggest to use search option in this forum and type those 2 terms. this topic is covered under E/M, OBGYN and probably under more specialty. I am learning these codes right now and compiling the information when i find it. Yes, they are different: G0438/G0439 is for Medicare patient 65+. There are documentation requirements. i just read a post that we can bill both 99387-99397 with mod 25 + G codes. There is a lot of infor. So let's search for it!

 

[sls314]

This link will help provide some information - it gives the required components for the AWV and other important information: https://www.cms.gov/Outreach-and-Ed...entive-services/medicare-wellness-visits.html

 

[medicalauditor]

Can someone help me understand the difference between a regular annual physical (99381-99397) and the Medicare annual wellness (G0439)? Is the documentation supposed to be different for the Medicare one?

The two services are completely different. An annual physical is a physical examination, reviewing patient's health and chronic medical conditions, ordering routine labs and screenings, reviewing and providing immunizations, etc. Medicare does not cover annual physicals. An annual wellness is more of reviewing activities of daily living, health risk assessment, etc. I am adding a brief list of the type of things included in an AWV. This is not comprehensive. Here's a link to Medicare's AWV guide and required elements: https://www.cms.gov/Outreach-and-Ed...ve-services/medicare-wellness-visits.html#AWV

• Check your weight and blood pressure
• Update the health risk assessment you completed
• Update your medical and family history
• Update your list of current medical providers and suppliers
• Update your written screening schedule
• Screen for cognitive issues
• Provide health advice and referrals to health education and/or preventive counseling services