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Primary Care Coding Alert

CPT 2011:

5 Tips Lead You to G0438, G0439 Coding Success

Published on Thu Jan 13, 2011

Boost your bottom line by reporting new annual wellness visits correctly. If you want your annual visit claims to be picture perfect in 2011, then follow these five tips to avoid future denials and keep your physician's claim on the fast track to success. Background: The Affordable Care Act (ACA) extended preventive coverage to more than 88 million patients covered by health insurance, and Medicare has codified that benefit in the form of an annual wellness visit. Medicare valued the new annual wellness codes based on a level 4, problem-oriented new and established E/M service. The two new codes are: G0438 -- Annual wellness visit; includes a personalized prevention plan of service (PPPS), first visit G0439 -- Annual wellness visit; includes a personalized prevention plan of service (PPPS), subsequent visit. Tip 1: Apply G0438 to Second Year of Coverage Be wary of applying these codes to new Medicare patients coming in to [...]
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