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Thread: Coverage for Annual Well Woman Exam

  1. #1
    Join Date
    Apr 2007

    Default Coverage for Annual Well Woman Exam

    AAPC: Back to School
    Does anyone have a list of how often each insurance covers the well woman annual exam? One of our providers wants to know which ones cover based on calander year and which carriers base coverage on the date...

    Christina Lee Wagner, CPC, CPC-H

  2. #2
    Join Date
    Apr 2007

    Default well woman exam

    We always schedule the well woman exam one year after the previous one. Not one day prior either... Many insurances have a one year rule to avoid max benefit limit amounts. However some have a two year or no preventative coverage at all. Hope this helps...Lucy

  3. #3
    Join Date
    Apr 2007


    We make it a rule to schedule well woman exams a year after the last one & no sooner, although we have found that some of the plans have begun to cover well woman exams only once every two years. We have had denials based on the exam being a day too early.
    Another thing to keep in mind is the diagnosis code. Most of them only want to see the V72.31 dx code.
    Darde G. CPC

  4. #4
    Join Date
    Apr 2007

    Smile well woman exams

    It's always advisable to contact the carriers directly to find out what their preventative benefit policy is. This is one of those issues that is payor specific so it's always best to go straight to the source.

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