Are You Missing Opportunities to Bill Payable Medicare Preventive Service? : IPPE and AWW


Preventive services help keep our Medicare population healthy.  Unfortunately, Medicare only covers some preventive services. IPPE and AWW services. These services have been payable since 2005 but in many cases are underutilized.  Implementing the IPPE, better known as Welcome to Medicare Evaluation, and the AWV, Annual Wellness Visit services in your practice provide value-added care to your Medicare patients as well as utilizing your staff more efficiently and improve your bottom line. We will discuss in detail these covered services which are different than the non-covered annual physical (9929x) and (9939X) 

The required documentation elements are very important and cannot be missed or the service may not qualify for billing.  In addition, there are some diagnostic services that may be referred as a result of the IPPE or AWV that may be covered.  Knowing when to bill separately for additional services during an IPPE and AWV encounter is important to your bottom line and the patient’s pocketbook.  Is your front desk scheduling appointments appropriately for preventive services? 

What additional services are not an inherent part of the IPPE and AWV?  Do your Medicare patients understand the difference between a non-payable annual physical and the IPPE or AWV?  Confusion in your Medicare population can cause customer service headaches. 

Why should you attend :

Make the most of payable IPPE and AWV to improve your office’s bottom line and to provide quality care to your patients.

Areas covered in the session:

  • Differences between the IPPE (G0402), the initial (G0438), and subsequent AWW (G0439) services
  • Frequency requirements associated with IPPE and AWV
  • Specific documentation to support billing.
  • Identify providers eligible to bill for IPPE and AWW services
  • Differences between the annual physical and IPPE/AWV
  • Billing additional services such as a problem-oriented service or a full annual physical (HME) at the same encounter as the IPPE/AWV.
  • Most common mistakes when documenting elements of the IPPE and AWV.
  • How to bill if the required elements are not documented
  • Additional payable diagnostic services that may be an outcome of the IPPE and AWV encounter
  • Appropriate diagnosis codes to support billing IPPE

Who should attend this:

  • Providers
  • Coders
  • Office Managers
  • Scheduling Staff
  • Reimbursement Managers
  • Denial Managemen Team
  • Customer Service Representatives

Jan Rasmussen, PCS, CPC, ACS-OB. Jan is an independent consultant and President of Professional Coding Solutions.  She has been involved in coding and reimbursement for over 40 years specializing in physician billing and documentation issues. Jan was previously employed with the State Medical Society of WI as a coding education consultant. In her role as an educator she has developed and presented CPT, ICD, primary care, surgical specialty and audit process seminars. Jan previously served on the Board for Advanced Medical Coding with Decision Health in Rockville, Maryland publishers of Part B News and was a technical editor of the OB/GYN monthly specialty focused “Pink Sheet”.

She has been teaching E/M since 1992 to both physician and coding audiences.  As an auditor she has been involved in government PATH audits, Champus and compliance documentation assessments.  Jan has been a CPC since 1993 and previously served on the AAPC Advisory Board as the laison to the AMA.  In 1994, Jan was honored by AAPC as Networker of the Year.  She was slso a Regional Governor for the American College of Medical Coding Specialists (ACMCS). 

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