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Showing posts from March, 2016

The ABCs of the Annual Wellness Visit (AWV)

Medicare offers participants an Annual Wellness Visit (AWV) which is not an appointment for a "physical", although it is easy to see why some may think it is. It should be thought of more like a "getting to know you" or "interview" visit.  It can be thought of setting a base line of information. Beneficiaries can qualify for this if they: ■ Are not within the first 12 months of their first Medicare Part B coverage period; and ■ Have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months.   Translated that means : if they have not had one of these done already AND that they haven't had a IPPE either, in the last year.  It is possible to check a data base to see if they have already had any of these services.  Inquiry with your employer. This document is divided into two sections: the first explains the elements of a beneficiary’s initial AWV; the second explains the elements of all subsequent AWVs.  Y

Medicare National Coverage Determinations (NCD)

The purpose of the NCD Manual is to describes whether specific medical items, services, treatment procedures, or technologies can be paid for under Medicare.  On this website you will find Coverage Determinations divided by Chapter 1 and four Parts. Part 1 Sections 10 - 80 Part 2 Sections 90-160.26 Part 3 Sections 170-190.34 Part 4 Sections 200-310.1 There is also a Crosswalk from NCD Manual to Coverage Issues Manual and a Crosswalk from Coverage Issues Manual to NCD                                                                                                                                 https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS014961.html