Wiki Office visit with G0438 V70.0

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bill2doc

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Would someone please clarify the G0438/39 codes with office visits. I'm very confused.

My doc sees patient for office visits and we never code for Well check of Physicial. Can someone please break it down for me as I feel we are looking revnue.

I need to be able to code it properly and advise the doctor how he needs to adjust his chart to capture the annual wellness....

Any help is greatly appreciate THANK YOU !!!!!!!
 
AWV and OV

I code for family practice and Internal medicine and we do this all the time. So of course like you wrote you would bill the Go438/39 with the V700, code for example a 99214 with 250.00, 401.9, 272.4. You would need proper documentation to support both codes, clearly delineating between the AWV and the office visit.
At out organiziation we have combined all documentation needs for the IPPE and the AWV into one form so we have all criteria covered. This is now a 5 page form that the provider/nurse/and patient must fill out at the time of the encoutner. Which is nice because the scanned, 5 page form, stands alone for the AWV/IPPE encounter and the provider just dictates the OV portion of the encounter.
I hope I've interpreted your question correctly.
Jeff
 
You can code an office visit with the G0438/G0439, as long as documentaiton is separate and that you don't double-dip (i.e using the same PFSH for both visits, for example). Here's my two cents: The thing to think about is that the AWV is of no cost to your patient, but the office visit will bump up against a deductible and co-insurance, which will incur some cost to some of your patients. Make sure they are aware at the time of service that you'll be adding an additional charge to their bill. Most seniors do not understand (or like) that we can bill two services at the same time when they are only in the office once! We decided that the patient dissatisfaction with the added office visit charge (when they thought they were getting their "free" exam) wasn't worth the negative press, so to speak. You are well within your rights to bill both services, but be aware that your billers might be fielding some angry calls.
 
ALso you need to prepare for ICD-10 CM, the annual/preventive visit codes in the ICD-10 CM state they are to be use without complaint, suspected or reported diagnosis. The only other dx code you can use with the preventive Z00.0x is if there is a documented abnormal finding which is Z00.01.
 
Thanks to you all. Jeff, is your form something that you would be willing to share? We are trying to come up with the paperwork required for the patient to complete and put in the file. I haven't been able to find a templet. Please advise if you are willing to share your copy or direct me to where I may find a templet. Thanks again to you all !!
 
Pam you bring up a good point, we have not had any reprocussion from split billing, yet. We continue doing this as a service to our elder patients so they do not have to make two appointments for both the AWV and the office visit. That may all change in the future as we are in the works of implementing the 'nurse' model of the AWV, which means we'll be having an RN perform this service and then the patient will have not choice but to make another appointment.

bill2doc
I work for a large organization so sharing the form would be grounds for me to loose my job. I could make some suggestions as to what should be on your form though. That maybe something we should take offline. My personal email address is wilski64@live.com if you'd like to follow up on this subject.
 
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