Medicare wellness, IPPE and annual wellness visits

I have a physician who is questioning the wording regarding the physical exam elements of both the IPPE and the annual wellness visit: the IPPE specifies "physical exam that includes height, weight, BP, screening for visual acuity and other exam components as deemed appropriate by MD or NPP" This physician wants to split the visit into "wellness" and "clinical" halves in order to bill an E/M with the IPPE and feels that any exam elements relating to follow-up of chronic ongoing problems is clinical. I interpret them as part of the wellness visit. Which is right?

Scenario 1: Patient arrives for IPPE, no new complaints, but during exam, topic of chronic arthritis GERD and hypertension are discussed.

Scenario 2: Patient arrives for IPPE, and presents with URI in addition to having IPPE.

re: Medicare wellness, IPPE and annual wellness visits

Your doc is correct- the wellness visit does not require an exam per se except vitals.

1- Bill wellness visit and 99213-25 with 401.1, 530.81, 715.9x. Be sure the A&P clearly separates the wellness and problem discussions.

2- wellness plus 99212-25 with 465.9, or 99213-25 with 461.9 if antibiotics prescribed. again, be sure A&P is separate