Menu Close

What is the difference between G0402 and G0438?

What is the difference between G0402 and G0438?

A – No, the IPPE is the Initial Preventive Physical Examination, also known as the “Welcome to Medicare” visit (G0402), while the initial AWV (G0438) is the patient’s first Medicare AWV following the IPPE.

What is the difference between G0439 and 99397?

A full physical exam, 99397, is different than an Annual Wellness Visit, G0438/G0439, or “Welcome to Medicare Exam”, G0402. A full physical 99397 or 99387 is NOT covered by Medicare and patients are responsible for the cost and can be billed.

What is the billing code for annual wellness visit?

The two CPT codes used to report AWV services are: G0438 initial visit. G0439 subsequent visit.

How do I code Medicare Annual Wellness visit?

Medicare Benefit: Annual Wellness Visits Covered Medicare has two HCPCS codes for these wellness visits for medical billing purposes. The codes are G0438 and G0439.

Is G0438 only for Medicare?

Two key things to know about G0438: It can only be used for a Medicare beneficiary who is no longer within the first 12 months after the effective date of their Part B coverage; and.

What is procedure code 99395?

CPT® 99395 in section: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and more.

What is the ICD 10 code for Medicare Annual Wellness visit?

G0438
An initial Annual Wellness Visit code is documented using G0438, subsequent Annual Wellness Visits are documented using code G0439.

What is GT modifier used for?

The GT modifier is used to indicate a service was rendered via synchronous telecommunication.

What is a 59 modifier used for?

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.

What code is G0438?

G0438 is the HCPCS code you should use when coding a patient’s first annual wellness visit. Its long descriptor is “Annual wellness visit, includes a personalized prevention plan of service (PPPS), first visit,” while its short descriptor is “Annual wellness first.”

What does CPT stand for in medical billing?

CPT (Common Procedural Technology) codes are numbers assigned to every task and service a medical practitioner may provide to a patient including medical, surgical, and diagnostic services.

How are HCPCS codes used in Medicare billing?

HCPCS Codes HCPCS codes are used and maintained by the Centers for Medicare & Medicaid Services (CMS) and are used to bill Medicare, Medicaid, and many other third-party payers. There are two levels of codes: 2 Level I codes are based on CPT codes and used for services and procedures usually provided by physicians.

What is the CPT code for Welcome to Medicare annual wellness visit?

THE WELCOME TO MEDICARE ANNUAL WELLNESS VISIT SERVICE IS BILLED USING THE CPT CODE G0402. This should get paid because this is the first wellness visit after the patient got her Medicare.

How does medical billing work in the hospital?

The billing department then submits a list of the services you were provided to your insurer or payer. Doctors and facilities generally use electronic means to store and transfer this information, although some may still be done by mail or fax.