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Thread: Coders: Annual Wellness Visit--Read the Guidelines!!

  1. #11
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    Apr 2007
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    Promo: Code Books
    Quote Originally Posted by dawnsilva View Post
    Not quite sure how is it a contradiction if this is what CMS is stating the wellness visit is?
    Well, your previous post pointed it out. "preventive physical exam" which is an Annual Wellness Visit.

    In reading the criteria for the AWV, there's precious little exam component.

    I didn't intend to incite an argument, just suggested that everyone use the language that will be most clear to our patients and providers.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  2. #12
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    Quote Originally Posted by brake View Post
    I'm trying to educate my providers and staff; are there any forms or checklist to prompt questions to the patients from the providers so the documentation will be correctly indentified by the criteria? Thanks


    Chiquita S. Brake,CPC
    I can send you the FAQs I prepared for my providers and our patients. I also have a checklist for the guidelines.


    Send me a PM, with your email, and I'll be happy to get that to you.

    Pam
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. #13

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    Good Afternoon Ms. Brooks
    Is there any way that you could share your FAQs for the provider and patient as well as your checklist for the guidelines. I'm trying to provide my physicians with a better clarification on this new Annual Wellness Visit. I would really appreciate it.

    Margie Delgado
    mdelgado@norwalkmedgroup.com

    Thank you in advance
    Margie Delgado

  4. #14

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    Quote Originally Posted by LindaEV View Post
    You can use the G codes on the same day (no modifier needed). Also applies to a sick visit...and yes you would add a -25 on that one.
    I have just received my first EOB from Medicare for 2011 whick I billed E/M visit with the AWV. Medicare has paid the OV and denied the AWV due to non covered services because this is a routine exam done in conjuction with a routine exam. Modifier 25 was added to OV code. Would we also add another modifier to the AWV? Desperate help needed, we have done 175 of these exams.

  5. #15
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    Columbia, MO
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    what was the reason for the ov?

    Debra A. Mitchell, MSPH, CPC-H

  6. #16
    Join Date
    Apr 2007
    Location
    New Orleans
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    Default Awv

    Hi Pam could you please send me a copy of your FAQ and checklist:



    Thanks
    gwenmperkins@yahoo.com

  7. #17
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    Apr 2007
    Location
    Evansville Indiana
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    In a teleconference from NGS yesterday, we were told to hold these claims until 4/4/2011 because that is the implementation date. They said that if you bill them now they should be paid but would not be tracked properly until 4/4. They also stated that if you use V70.0 for dx it would be denied. They could not give an appropriate dx however. They said that they were going to try to get there systems to accept the V70.0 when billed with these codes and would let us know if and when they did. They highly advised holding these claims until 4/4.

    LeeAnn

  8. #18

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    No, G0438 is not dependent on the Welcome to Medicare IPPE visit. That is not an annual benefit. The
    G0438 is used for the First Annual Wellness Visit- Other than the mandatory time lapse, it doesn't matter if the patient did or did not have the IPPE. The G0438 is used the first time the patient takes advantage of the annual wellness visit. Every year after that, the G0438 will be used to indicate that it is a subsequent wellness visit and that the first annual wellness visit has been performed - by your office or another. That is not a factor.

  9. #19

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    No, G0438 is not dependent on the Welcome to Medicare IPPE visit. That is not an annual benefit. The
    G0438 is used for the First Annual Wellness Visit- Other than the mandatory time lapse, it doesn't matter if the patient did or did not have the IPPE. The G0438 is used the first time the patient takes advantage of the annual wellness visit. Every year after that, the G0438 will be used to indicate that it is a subsequent wellness visit and that the first annual wellness visit has been performed - by your office or another. That is not a factor.

  10. #20

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    LeeAnn,

    I'm really curious to hear if providers were allowed to respond to NGS" instructions to hold these claims until April? Were they allowed to give feedback?

    Melanie

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