ANnual wellness visits- patient seen too soon

Does mediare give any leeway if it hasn't not been exactly one year between annual wellness visits. I saw a patient may 5 2011 for his initial AWV. He came in early for the subsequent AWV on April27th. Will mediare deny that claim or is their a 30 day leeway?

re: ANnual wellness visits- patient seen too soon

Pursuant to section 4103 of the Affordable Care Act of 2010 , the Centers for
Medicare & Medicaid Services (CMS) amended sections 411.15(a)(1) and 411.15
(k)(15) of 42 CFR (list of examples of routine physical examinations excluded from
coverage) effective for services furnished on or after January 1, 2011. This
amendment’s expanded coverage is subject to certain eligibility and other
limitations that allow payment for an AWV, including PPPS, for an individual who is
no longer within 12 months after the effective date of his or her first Medicare Part
B coverage period and has not received either an initial preventive physical
examination (IPPE) or an AWV within the past 12 months.

re: ANnual wellness visits- patient seen too soon

Question:
The patient wants the AWV before it has been 12 months since the previous AWV or Initial Preventive Physical Examination (IPPE). Must I provide the patient with an Advance Beneficiary Notice of Noncoverage (ABN)?
Answer:
The timing of these services is a statutory benefit and therefore services outside the payable periods do not require an ABN

re: ANnual wellness visits- patient seen too soon

Question:
The guidelines on the AWV show that Medicare will allow the service once per year. Is this a 365-day year or 12 calendar months?
Answer:
Medicare would look to verify that at least 11 full calendar months have passed since the last AWV.

re: ANnual wellness visits- patient seen too soon

Question:
What does the Remittance Notice state when denying the visit if one year has not elapsed between the Initial Preventive Physical Exam (IPPE) and the AWV?
Answer:
CWF (Common Working File) will count 11 full months starting with the month a paid IPPE is in the beneficiary's history file.
Remittance Reason Code 119: Benefit maximum for this time period or occurrence has been reached.
Remittance Remarks Code N130: Consult plan benefit documents/guidelines for information about restrictions for this service.
Group Code: PR (Patient Responsibility)

re: ANnual wellness visits- patient seen too soon

http://www.wpsmedicare.com/part_b/resources/provider_types/awv-faq.shtml

re: ANnual wellness visits- patient seen too soon

So 11 months is not quite 12 months or 365. Hence will Medicare approve the claim if within 30 days from a full year?

re: ANnual wellness visits- patient seen too soon

Probably