Wiki FQHC Medicare Preventive

[jbhuju]

hello all
i have a question, i do work in FQHC and have a question on medicare annual wellness c=visit code. as being FQHC do we bill G0468 as innitial or subsequence visit for AWV or do we use G0438 or G0439. please help. and i live in Arizona.
thank you

 

[cjtown]

You will bill both codes on the claim.
G0468 – FQHC visit, IPPE or AWV: HCPCS Qualifying Visits for G0468
G0402 Initial preventive exam
G0438 Ppps, initial visit
G0439 Ppps, subseq visit

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-PPS-Specific-Payment-Codes.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-Preventive-Services.pdf

Hope this helps.
Carla

 

[jbhuju]

You will bill both codes on the claim.
G0468 – FQHC visit, IPPE or AWV: HCPCS Qualifying Visits for G0468
G0402 Initial preventive exam
G0438 Ppps, initial visit
G0439 Ppps, subseq visit

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-PPS-Specific-Payment-Codes.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-Preventive-Services.pdf

Hope this helps.
Carla

thank you so much yes it does help

 

[samanthacchc@gmail.com]

thank you so much yes it does help

Do you also have to add an E/M code? Our billing software is just placing the claim in hold.

 

[sachintyagi]

G0402 for welcome to medicare program, once in life time while G0438 initial visit and G0439 sub visits----