Rita B. Conley
Guest
I have a general question. If a component is missing from the IPPE or AWV required documentation elements (for example, the initial AWV requires a list of the patient's health care providers...what if this piece wasn't documented), how strict would you be relative to allowing the billing of the AWV for this visit with feedback/education to the provider and if pattern develops, then you would not allow G0438? I cannot find any guidance from Medicare on what to "down code" to...would I drop the visit to a preventive medicine code 99381-99397?
In Medicare's Guide to Preventive Services, under the AWV section, the documentation requirements read, "Documentation must show that the health professionals provided, or provided and referred, all required components of the AWV...," so with this, is it "black and white" that you would not allow the AWV and would then look to see if all elements of a preventive medicine service are covered so you could assign those codes instead?
I'd just like to seek opinions from others in this realm.
In Medicare's Guide to Preventive Services, under the AWV section, the documentation requirements read, "Documentation must show that the health professionals provided, or provided and referred, all required components of the AWV...," so with this, is it "black and white" that you would not allow the AWV and would then look to see if all elements of a preventive medicine service are covered so you could assign those codes instead?
I'd just like to seek opinions from others in this realm.