Wiki Medicare AWV Crosswalk

[bethany.tapp]

Hello,
I cannot find a crosswalk between preventative codes and the Medicare AWV codes. Is it safe to assume that 99381 - 99387 will convert to G0438 if the patient has Medicare? Is it safe to assume 99391 - 99397 will convert to G0439 if the patient has Medicare?

 

[thomas7331]

There is no crosswalk between these because they are very different services and it is not 'safe' to make the assumptions you have stated. 99381-99397 are preventive visits that include a history and exam. AWVs do not include exams and also have very different requirement from what is listed in CPT under the preventive service codes. In addition, the initial AWV is only allowed once in the patient's lifetime which is different from the CPT definition of a new patient visit.

Here is a link that to a CMS publication that will give you details of what exactly is required for the AWV:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AWV_Chart_ICN905706.pdf