Wiki prevent with annual wellness visit

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Borlickd

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I have been doing some research and want to see if anyone else out in the coding world knows the answer to my question. I am curious if we can bill CPT 99381 - 99397 along with an Annual Wellness visit if documentation supports. The only thing I have found was a powerpoint from the AMA 2010 and from what they are saying is yes we can bill both on the same day. Looking for more input - anyone that has more information, please let me know.
I appreciate any and all feedback :)

Thank You.
Danielle Borlick, CPC
 
I don't know of any documentation that suggests that you can (or should) bill both at the same time. Actually, Medicare does not cover 99381-99397. The IPPE and AWV are Medicare's answer to preventive care. Commercial payers may cover the 99381-99397, but may not recognize the G0402 and G0438-G0439.

Because there are elements of the IPPE and AWV that are expected to be documented also in the preventive codes, I'm not sure how you'd be able to justify separately identifiable documentation that would satisfy the requirements for both. For example, the description of CPT indicates that the preventive medicine services 99381-99397 should document anticipatory guidance and risk factor interventions that are provided. This information is also required per the IPPE and AWV. The preventive medicine documentation does not include just the head-to-toe physical, so if that's all you'd include for the supporting documentation, you really haven't met the full criteria for the code to be billed.

Billing both on behalf of a Medicare recipient would require your having to balance bill the patient for the 99381-99397 since it's categorically denied as a non-covered service....which we are discouraged (by our contractor, anyway) from providing to our Medicare recipients without their knowledge.
 
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