First annual wellness visit and GE or GC modifiers

I work in a residency program where the residents see the patients and are precepted by a faculty doctor. With the new annual well visit of G0438 do you use a modifier GE or GC when billing? GE would indicate the case was discussed with the preceptor and GC would indicate the preceptor saw and examined the patient and discussed the case with the resident. This is peculiar because there is no real exam done during these wellness visits, so the preceptor would really just be stepping in to see the patient. Please advise.

Our billing system definitely does not want the GE modifier added.

re: First annual wellness visit and GE or GC modifiers

Here's what the Medicare Claims Processing Manual says about doing the IPPE or AWV under the primary care teaching exception:

For services provided on or after January 1, 2005, the following code is included under
the primary care exception: HCPCS code G0344 - Initial preventive physical
examination; face-to-face visit services limited to new beneficiary during the first 6
months of Medicare enrollment.

For services provided on or after January 1, 2009, the following code is included under
the primary care exception: HCPCS code G0402 - Initial preventive physical
examination; face-to-face visit, services limited to new beneficiary during the first 12
months of Medicare enrollment.

Effective January 1, 2011, the following codes are included under the primary care
exception: HCPCS code G0438 – Annual wellness visit, includes a personalized
prevention plan of service (PPPS), first visit, and HCPCS code G0439 – Annual wellness
visit, includes a personalized prevention plan of service, subsequent visit.

Since GE indicates the service was provided without the presence of the teaching MD, but under the primary care exception, you can use the GE modifier with it. The GC is also allowed, if the attending comes in and sees and interacts with the patient as well. I think your system needs to be updated to allow the GE modifier.

The manual version changed recently to include the AWV.