Medicare Wellness and........

Can we charge a 99213, G0438, G0101 and Q0091 all together?
Thank You, Debbie

yep

99213-25 attached to 401.1, G001 and Q0091 with v72.31, and G0438 with V70.0; just be sure your documentation is clear in each section

Medicare wellness and......

I thank you very much.

Medicare wellness and o.v.--use caution

The Proposed Rule stated that they thought the scenario of billing a wellness visit and office visit would be "uncommon." The Final Rule was less emphatic, but said: no part of the documentation used for the wellness visit can be used to select the level of service for an E/M. So be careful about level of service, documentation of the sick visit.

I think the carriers will be looking for these and will ask to see documentation if they are billed together routinely.

From another forum discussing this exact issue

I’m glad the physician at CMS is on the ball, he pursued things more and contacted me back. He spoke to those that actually wrote the final rule. The proposed rule had language indicating that the AWV + E&M;visit with a modifier would be expected to be an unusual occurrence – and that is what the ACP site indicates. However, there was a lot of feedback and the final ruling removed that phraseology. He said that they will be contacting the ACP to advise them to change their site.

The combined AWV + E&M;can be done without concern about the frequency, as there is no suggestion of a restriction in the final ruling. Two things were noted in my conversation with him (1) if staff members do some or all of the AWV, the documentation should reflect who did the screenings/evaluation (2) the E&M;issues addressed must be clearly separate and distinct in the note so there is no confusion that two separate/combined evaluations were indeed performed.

and to help

I designed a checklist and a template for my EMR so everything is clearly separate