HCPCS Code for Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit G0438

Hint: Mastering the primary care exception rule helps open reimbursement doors. When your provider performs services as a teaching physician (TP), their coding may change quite a bit. A significant reason for that is the challenges inherent to supervising residents. [...]

Hint: Going forward, modifier 25 can be in play. The road to reimbursement for services provided under +G2211 has been long and bumpy, but the 2025 Medicare Physician Fee Schedule (MPFS) final rule may bring relief to clinicians and practices [...]

Question: When exactly do we need to perform and report social determinants of health (SDOH) assessments for Medicare beneficiaries? Kansas Subscriber Answer: The SDOH risk assessment is an optional element of the Medicare annual wellness visit (AWV) that providers can, [...]

Review the requirements of MWVs and AWVs. Regular checkups for patients is a given in any general physician (GP) practice. In this issue, we delve into the differences between adult preventive visits and Medicare Wellness Visits (MWVs). Read on for [...]

Review the requirements of MWVs and AWVs. In Primary Care Coding Alert Volume 26 Number 7, we uncovered helpful insights on preventive coding for kids. In this issue, we delve into the differences between adult preventive visits and Medicare Wellness [...]

Here’s what your physician’s documentation needs to include. Since January 1, you can use the new add-on code +99459 (Pelvic examination (List separately in addition to code for primary procedure)), but many coders are still confused as to how they [...]

Question: A Medicare patient who is high risk due to sexual behavior came in for her annual wellness visit. The ob-gyn did a Pap, and the office reported G0438 with Q0091. They ordered a repeat Pap six months later, due to [...]

Find out which Medicare codes aren’t compatible. Many coders may not feel confident about using the new add-on code +99459 (Pelvic examination (List separately in addition to code for primary procedure)), which has been available since Jan. 1. If this [...]

Here’s what your physician’s documentation needs to include. Since January 1, you can use new add-on code +99459 (Pelvic examination (List separately in addition to code for primary procedure)), but many coders are still confused as to how they can [...]

Get reimbursed for services you may be offering for free. According to a poster session at the American Society of Clinical Oncology’s (ASCO’s) 2021 Quality Care Symposium, too many hematology and oncology physicians are failing to report advance care planning [...]