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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.  Yes, there are two opportunities. Page 4 has information about what should be covered in the subsequent visit.

You must provide all elements of the AWV prior to submitting a claim for the AWV.  In other words, only submitted after you have done it.  NOTE: The AWV is a separate service from the Initial Preventive Physical Examination (IPPE).  These are two different things.


Page can be found at:
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AWV_Chart_ICN905706.pdf








Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.  This information is my own insight on the subject. The information presented herein is for general informational purposes only and is accurate as of the date of publication.



#HCC #ICD10 #CMS #ICD9 #RiskAdjustment  #MedicalCoding
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Location: San Diego, CA, USA

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