Coders: Annual Wellness Visit--Read the Guidelines!!
I have seen many threads on this topic that worry me...
Coders, I urge you to make sure you carefully read the MLN Matters MM7079 and the related CR Transmittal R134BP and R2109CP.
I see a lot of you using the words "Annual Physical", or "Preventive Physical". The Annual Wellness Visit is not a head-to-toe physical exam. This is a risk assesment to help physicians put together a patient-specific plan for preventive care. Physicians need to know exactly what criteria are expected for this high-RVU visit. It's up to us, as certified coders to make sure our physicans have the tools and information they need so that they can complete this visit with the appropriate documentation. Believe me, Medicare is going to be auditing this.
The press has erroneously reported that Medicare is now paying for preventive physicals or preventive exams, and our Medicare population is going to be calling your offices, asking for their 'free physical'. Based on the criteria for this covered service, the only objective portion of this encounter is the gathering of vitals. Let's not compound the problem by using the wrong language when describing these services. It will be up to us to educate the patients and our providers that this is not a physical exam, as would be reported by codes in the 99381-99397 range.
Pam Brooks, MHA, CPC, PCS, COC
Dover, NH 03820
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