Codes Discussed: 99381 (New patient preventive medicine service, infant younger than 1 year), 99382 (New patient preventive medicine service, early childhood age 1-4 years), 99383 (New patient preventive medicine service, late childhood age 5-11 years), 99384 (New patient preventive medicine service, adolescent age 12-17 years), 99385 (New patient preventive medicine service, age 18-39 years), 99386 (New patient preventive medicine service, age 40-64 years), 99387 (New patient preventive medicine service, age 65 years and older), 99391 (Established patient preventive medicine service, infant younger than 1 year), 99392 (Established patient preventive medicine service, early childhood age 1-4 years), 99393 (Established patient preventive medicine service, late childhood age 5-11 years), 99394 (Established patient preventive medicine service, adolescent age 12-17 years), 99395 (Established patient preventive medicine service, age 18-39 years), 99396 (Established patient preventive medicine service, age 40-64 years/annual physical case example), 99397 (Established patient preventive medicine service, age 65 years and older), G0402 (Initial Preventive Physical Examination/IPPE/Welcome to Medicare), G0438 (Initial Annual Wellness Visit/first AWV), G0439 (Subsequent Annual Wellness Visit), G0403 (Screening electrocardiogram for IPPE, routine ECG with 12 leads with interpretation and report), G0404 (Screening electrocardiogram for IPPE, routine ECG with 12 leads, tracing only without interpretation and report), G0405 (Screening electrocardiogram for IPPE, routine ECG with 12 leads, interpretation and report only), modifier 33 (Preventive services modifier, used with advance care planning and physical activity/nutrition risk assessment when applicable), G0444 (Annual depression screening), G0442 (Alcohol misuse screening, 15 minutes), G0443 (Brief face-to-face counseling for alcohol misuse, 15 minutes), G0136 (Administration of standardized evidence-based physical activity and nutrition assessment, 5-15 minutes), 99497 (Advance care planning, first 30 minutes, face-to-face with patient, family member[s], and/or surrogate), 99498 (Advance care planning, each additional 30 minutes), PHQ-2 (Depression screening tool referenced in case examples, not sufficient for G0444), PHQ-9 (Depression screening tool required for G0444), AUDIT (Alcohol screening tool referenced in case examples), STEADI (Fall risk screening tool referenced in case examples), ACP (Advance Care Planning), AWV (Annual Wellness Visit), IPPE (Initial Preventive Physical Examination), HRA (Health Risk Assessment), ADLs (Activities of Daily Living), IADLs (Instrumental Activities of Daily Living), BMI (Body Mass Index), ECG/EKG (Electrocardiogram), BP (Blood pressure), PCP (Primary care physician/practitioner)
Topics Covered: AWV coding, Annual Wellness Visit coding, annual physical coding, preventive medicine service coding, Medicare wellness visit coding, IPPE coding, Welcome to Medicare visit coding, preventing errors in AWV reporting, preventing errors in annual physical reporting, comprehensive preventive medicine, annual preventive visit, preventive annual physical, age-appropriate history and exam, gender-appropriate history and exam, preventive counseling, anticipatory guidance, risk factor reduction, asymptomatic preventive services, current overall health review, comprehensive physical exam, bloodwork in annual physicals, diagnostic tests in annual physicals, new patient preventive medicine codes, established patient preventive medicine codes, preventive medicine documentation, age and gender appropriate comprehensive exam, provider-determined preventive exam, counseling and anticipatory guidance examples, exercise counseling, diet counseling, social media counseling, TV time counseling, drugs and alcohol counseling, sleep counseling, appropriate screenings, associated labs and studies, recommended immunizations, stable chronic illness review, prescription review, trivial or insignificant problems during preventive visit, Medicare preventive visits, Medicare-covered wellness services, personalized prevention plan, disease prevention, disability prevention, health risk factors, routine measurements, height measurement, weight measurement, blood pressure measurement, Medicare wellness visit does not include comprehensive physical exam, IPPE eligibility, first 12 months of Medicare Part B enrollment, once-per-lifetime IPPE, IPPE provider requirements, IPPE diagnosis coding, AWV diagnosis coding, no specific CMS-required diagnosis code, appropriate diagnosis code selection, IPPE medical and social history review, past medical history, surgical history, medication review, supplement review, family history, hereditary conditions, diet review, physical activities, social activities, alcohol use, tobacco use, illegal drug use, depression risk factor review, mood disorder review, standardized depression screening tools, functional ability review, safety level review, activities of daily living, ADL review, fall risk assessment, hearing impairment screening, home safety review, IPPE minimum exam, BMI measurement, waist circumference measurement, visual acuity screening, end-of-life planning, advance directive discussion, opioid prescription review, opioid use disorder risk, current pain review, pain treatment plan review, non-opioid treatment options, specialist referral, substance use disorder screening, SUD risk factors, preventive education, preventive counseling, preventive referrals, written preventive plan, once-in-a-lifetime screening ECG, screening EKG coding, IPPE ECG coding, initial AWV timing, first AWV timing, AWV after IPPE, AWV outside first 12 months of Medicare eligibility, AWV provider requirements, medical professional AWV team, direct physician supervision, first AWV health risk assessment, HRA requirement, demographic data, self-assessment of health status, psychosocial risks, behavioral risks, instrumental activities of daily living, IADLs, medical and family history establishment, current provider list, current supplier list, cognitive impairment detection, direct cognitive observation, family concerns for cognition, clock draw test, word recall test, depression risk factor review for AWV, routine measurements in AWV, primary prevention interventions, secondary prevention interventions, tertiary prevention interventions, mental health risk factors, written screening schedule, five-to-ten-year screening checklist, functional ability and safety review, personalized health advice, fall prevention counseling, nutrition counseling, physical activity counseling, tobacco cessation counseling, social engagement counseling, weight loss counseling, cognition counseling, advance care planning in AWV, opioid prescription review in AWV, substance use disorder screening in AWV, HRA required for AWV but not IPPE, subsequent AWV timing, annual AWV coverage, one subsequent AWV per year, 11-month timing rule, subsequent AWV checklist, update HRA, update medical and family history, update current providers and suppliers, update written screening schedule, update risk factors, furnish personalized health advice, IPPE and initial AWV once-per-lifetime benefit, AWV based on patient not provider, new-to-clinic AWV selection, subsequent AWV after prior initial AWV, preventive medicine visit versus Medicare wellness visit, Medicare noncoverage of preventive physicals, Medicare coverage of wellness visits, IPPE versus initial AWV versus subsequent AWV, use-it-or-lose-it IPPE, AWV chart review, G0439 case review, missing cognitive impairment detection, AWV documentation checklist, adult health examination documentation, screening mammogram recommendation, colon cancer screening status, vaccine review, vision exam recommendation, dental exam recommendation, general health counseling, exercise counseling, diet counseling, home safety counseling, current care team review, health risk review, past medical history update, surgical history update, family history update, social history update, substance use documentation, alcohol use documentation, tobacco use documentation, illicit drug use documentation, HRA and ADL questionnaire documentation, hearing impairment documentation, home and community safety documentation, fall risk documentation, advanced directives documentation, annual physical case review, 39-year-old annual physical coding, comprehensive physical exam documentation, vitals documentation, BMI documentation, constitutional exam, skin exam, eye exam, ENMT exam, neck exam, respiratory exam, cardiovascular exam, abdominal exam, psychiatric exam, G0402 case review, missing visual acuity screen, Medicare Wellness First documentation, PHQ-2 screening, AUDIT screening, STEADI fall risk completion, ADL questionnaire, home safety assessment, locked firearms documentation, surgical history review, family history review, social history review, personalized screening recommendations, Cologuard screening, bone density screening, cervical cancer screening, COVID booster recommendation, advance care planning discussion, G0402 checklist, initial Medicare exam, hypertension documentation, polyps documentation, tobacco use documentation, colonoscopy screening history, Hepatitis C screening history, diabetes screening history, Pap screening history, mammogram screening history, osteoporosis screening, DEXA order, cognitive screening, Mini-Cog, clock draw, ADL ability, Prevnar administration, tobacco cessation counseling, Quitline referral, nicotine patch history, advanced directives declined, missing current providers and suppliers list, Medicare screening and preventive services, other Medicare preventive services, annual depression screening, depression screening with Medicare wellness visits, depression screening bundled into IPPE, depression screening bundled into initial AWV, depression screening billable with subsequent AWV, PHQ-9 requirement, G0444 primary care setting requirement, depression care supports, accurate diagnosis support, treatment follow-up support, alcohol misuse screening, brief alcohol misuse counseling, annual alcohol screening coverage, alcohol counseling frequency, positive alcohol screen counseling eligibility, competent and alert requirement, primary care setting alcohol counseling, time documentation for alcohol screening and counseling, physical activity and nutrition risk assessment, optional physical activity and nutrition assessment with AWV, assessing patient histories, assessing patient risk, prevention decision-making, diagnosis decision-making, care and treatment planning, coinsurance waiver requirements, deductible waiver requirements, same-day AWV requirement, same provider requirement, same claim requirement, annual reimbursement with AWV, advance care planning with wellness visits, advance directive discussion, voluntary ACP discussion, ACP waiver with G0438 and G0439, ACP modifier 33 usage, ACP time documentation, ACP 16-minute threshold, ACP time separately documented from other billable services, ACP discussion summary, EHR storage of completed documents, Medicare wellness documentation errors, AWV audit risks, annual physical versus AWV confusion, Medicare preventive service coding education, outpatient preventive visit coding, medical coding webinar content
going through examples helped a lot