Coding Information:

New Medicare Codes:

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. Medicare coinsurance and Part B deductibles do not apply to the AWV. The AWV will include the establishment of, or update to, the individual’s medical and family history, measurement of his or her height, weight, body-mass index (BMI) or waist circumference, and blood pressure (BP), with the goal of health promotion and disease detection and fostering the coordination of the screening and preventive services that may already be covered and paid for under Medicare Part B.

Information obtained from www.cms.gov 

You can access the full article at:  http://www.cms.gov/MLNMattersArticles/downloads/MM7079.pdf

G0402 - Initial Preventive Physical Exam (IPPE) or Welcome to Medicare Exam to be billed within the first year of a beneficiary joining Medicare

G0438 - AWV - Annual Wellness Visit

This is to be used after the beneficiary past their 12 months of joining Medicare. 

G0439 - Subsequent Annual Wellness Visits every 12 months

Diagnosis code V70.0 - A glitch in Medicare's system was denying the diagnosis code of V70.0 for these codes, but have fixed the problem. 

For all new information regarding ICD 10 please refer to:

http://www.cms.hhs.gov/ICD10/02m_2009_ICD_10_CM.asp#TopOfPage

ICD 10 Implementation:

"The Next Generation of Coding" Fact sheet can be downloaded at:

http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10factsheet2008.pdf

To see a sample of the ICD 10 Superbill:

http://www.cms.hhs.gov/ICD10/Downloads/Sample_superbill_icd10.pdf

A transcript of all the question and answer conferences are posted on the ICD-10 Web Page at http://www.cms.hhs.gov/ICD10.