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Lynda Wetter

Lynda Wetter

True Blue
Local Chapter Officer
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515
Location
Glen Allen, VA
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To bill a G0439 would we have to have done the G0438 on the patient?
What if they are coming form another facility. I feel like it's okay but wanted to see.
 
Medicare allows 1 G0438 only once in a members lifetime. If another provider previously billed the initial AWV and your office does also, your G0438 will be denied as exceeding the lifetime maximum.
 
Your Provider did not need to perform the G0438 to bill the Subsequent visit
G0439. In order to bill the G0439 this visit must be following 12 months after their initial visit. There are some Beneficiaries that do not receive the initial within the first 12 months of having Medicare - those patients would qualify for the Susequent visit. Here a few links that may be helpful.

http://cms.hhs.gov/

http://www.medicare.gov

http://www.palmettogba.com/medicare

I hope this helps,
 
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