Wiki Medicare Wellness Exams with separate E/M

[clopez]

Hello,

Currently I'm conducting an audit for all Medicare wellness visits that have a separate E/M to make sure there is supporting documentation to bill the separate E/M.

What I'm finding is that the majority of the encounters the providers are documenting the patients' chronic conditions with a status, perform a comprehensive exam and the assessment will say HTN stable continue current meds. Sometimes they will include skin conditions, urinary conditions or neoplasms and say to continue follow up with the specialist.

I don't agree that this supports a separate E/M since I don't see it as significant problems or that the provider is going above and beyond.

Any thoughts opinions would be greatly appreciated!

 

[ajgibson]

Hello,
I was under the impression that to bill an additional E/M visit with a wellness visit, that not only should the issue addressed be an acute issue, but more needs to be done beside a referral or "just watch it". A medication should be prescribed, a lab or diagnostic test should be ordered, etc...

Anyone else?