Wiki Subsequent Annual Visits

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ohiocoder101

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Hello All,

I was hoping someone could help me out, we are being told by Medicare-CGS that as of April 28 they are no longer covering the subsequent annual wellness visit. We have not recieved any notices/updates from Medicare on this and was wondering if any one else with CGS has heard this?

I tried searching on their website for info but cannot find anything...


Thanks in advance!

Julie
 
Interesting new information.....

I am not finding anything either....when you mean you were told by Medicare-CGS but not given any notifications/updates, how were you alerted with this new information, from the call center by a phone rep?

I am not finding anything on CMS either. I would call and verify again with a liver person if I were in this same situation, just a thought.

http://www.cgsmedicare.com/kyb/pubs/mb_J15/2014/02_2014/index.html#010
 
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Hi OCD

Yes we called on a claim (twice) that denied for these services and both times the call center reps stated this. One of other girls I work with will be asking our provider relations rep next week when she sees her at an upcoming meeting. I love how Medicare works- they will pay for something for awhile and then all of the sudden decide it is not beneficial. If this is true, it is going to be hard to train our docs to not bill for them, when we have stressed to bill. Ugh... frustrating!
 
I too bill for CGS, and right now the only time we get denials is when a 2nd AWV is billed when the 12-month-calendar date requirements are not met for the 2nd service. This occurs when the billing provider is unaware another provider has billed for this service and the patient was unaware/uninformed that this occured. Is this a possibility?

Or was another service (E&M) performed on the same DOS as the denied claim(s)?

I think there might be more to this scenario that we understand, please keep us informed on what you find out.
 
Something is not right with this. These annual wellness codes were created by CMS to be used specifically for Medicare patients. I think perhaps there is something else wrong with the claim. Just because a person on the phone told you this does make it a fact. I definitely would contact your CMS regional office to verify this. What does the denial notice state?
 
thank you both for your imput! I was not the one working the denied claims but it was a discussion in our office, I will have to find out more. I just find it odd that Medicare suddenly started denying claims. Ill keep checking this post and update once we hear from our provider relations rep next week.

thanks again
Julie
 
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