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Thread: Annual Wellness Visit

  1. #11


    AAPC: Back to School
    What ICD-9-CM code would you report with the AWV? Would you use V70.0?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #12

    Default AWV Diag code

    I have submitted my claims with the V70.0 diagnosis code for the G0438 and they are being denied as 'Non Covered diagnosis code", when I contacted NHIC< My MC Contractor> and I asked them to direct me to the documentation that stated what Diagnosis code to use I was informed that they have not received any directions from Medicare as to which diagnosis code to use, and that when they did they would post it on their website.

  3. #13


    Medicare members have been told by CMS more than once that the AWV IS an exam. On Medicare.gov it states "Starting January 1, 2011, Medicare will cover two types of physical exams—one when you’re new to Medicare and one each year after that."

  4. #14

    Smile G0438

    Medicare says they do not have guidelines stating what Diagnosis to use with the G0438 or G0439. I am thinking the Routine Exam Code would work: V70.0. Just want to be sure because they are so tricky!

    What is your opinion on this Pam or anyone out there that has already been paid, etc.

    Thank you!


  5. #15
    Join Date
    Apr 2007

    Unhappy can I get a copy

    could you please fax me a copy of what you are using. I have tried to explain this to my doctors....but they are still trying to do a PE. Ordering bone scans and what not...help please. my fax is 703-257-6709 thank you
    Last edited by deut649; 03-12-2011 at 08:40 AM. Reason: forgot my fax number

  6. #16


    If at all possible I would also like to get a copy of what the other person is using as well. If you could email me what you are using for the Dr's that would be much appreciated. thank-you


    Amy Miller, CPC

  7. #17

    Default Share


    Would you be willing to share your FAQ sheets?

    Kim Shufelt, CPC
    Seton Health
    Director of Primary Care Business Operations
    Troy, NY

  8. #18


    The link for the FAQ didn't work

  9. #19
    Join Date
    Apr 2007


    Medlearn Matters has wonderful material on the Well Visit HCPC codes and the ICD9 codes. Visit the CMS website and look for the MLMatters link.

  10. #20


    Quote Originally Posted by Pam Brooks View Post
    We've had to do a great deal of education for our providers (what must be documented to meet the criteria to bill), to our practice managers/office staff (when patients call...this is not a physical), and for our patients....that they not expect a physical.

    I developed a FAQ sheet for both my providers (because we use an EMR and our software has yet to be developed to capture the data required by CMS) and patients (because they haven't read the nearly 200 page update that was sent to them in September, that does tell them that this is a risk assessment and not a head-to-toe physical) since our practice managers and front desk staff were getting caught in the middle.

    I'd encourage all of you to organize your practices to be able to provide this service as soon as you are able. The RVUs are generous. There is a list of the documentation criteria which can be made into a paper form if you are not on an EMR.

    Instead of complaining about CMS (or the healthcare act) ...I'm grateful. I will never be unemployed!
    Is there any you would be willing to share the FAQ sheet you developed? I am searching for a user-friendly template to provide our physicians with in order to comply with CMS. Any help you could provide would be appreciated.

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