Wiki Medicare AWV & Diagnosis Codes

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rstroup

rstroup

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Jackson, MO
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I know with E&M codes 99202-99205 and 99212-99215 we only code diagnoses that the provider addressed and managed or affects the MDM. What I need help with is understanding what diagnoses to pull for annual exams. I chose Medicare AWVs because most of these patients usually have a significant medical history or numerous chronic issues. Our providers frequently add 12+ diagnosis codes to these encounters (I actually had one recently that had over 25 diagnoses). I know with preventive exams, the provider is going to review past medical history, current medications, any chronic conditions, etc. so the patient may indeed have all of these diagnoses. How do I go about choosing which diagnosis codes to keep, especially when there are more than 12 diagnosis codes - not to mention only 4 are actually mapped to the preventive code on the claim? Keep in mind, these are established diagnoses that are already being managed, either by the PCP or respective specialists.
 
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rstroup said:
I know with E&M codes 99202-99205 and 99212-99215 we only code diagnoses that the provider addressed and managed or affects the MDM. What I need help with is understanding what diagnoses to pull for annual exams. I chose Medicare AWVs because most of these patients usually have a significant medical history or numerous chronic issues. Our providers frequently add 12+ diagnosis codes to these encounters (I actually had one recently that had over 25 diagnoses). I know with preventive exams, the provider is going to review past medical history, current medications, any chronic conditions, etc. so the patient may indeed have all of these diagnoses. How do I go about choosing which diagnosis codes to keep, especially when there are more than 12 diagnosis codes - not to mention only 4 are actually mapped to the preventive code on the claim? Keep in mind, these are established diagnoses that are already being managed, either by the PCP or respective specialists.
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The system I work at reports the additional codes with cpt code 99499. You could also use code 99080. I believe it depends on how your EMR is setup/ what code your EMR likes. We report 24 diagnosis codes when it is applicable. Maybe have someone reach out to your EMR people.

 
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