Medicare Advantage Program Coding for Welcome to Medicare and Annual Wellness Visits
IMPORTANT REMINDER: Florida Blue, as a Medicare Advantage plan with four contracts with the Centers for Medicare & Medicaid Services (CMS), reminds you that Medicare Advantage Members are eligible for one Welcome to Medicare visit as well as an Annual Wellness visit. When filing these Medicare Advantage visit claims, it is important for you to use the correct procedure codes r to avoid claim denials.
• G0402 - Initial Preventive Physical Examination (IPPE) or Welcome to Medicare Visit
• G0438 - Annual Wellness Visit (AWV); includes a personalized prevention plan (PPPS)
• G0439 - Subsequent Annual Wellness Visit (AWV); includes a personalized prevention plan (PPPS)
Also, please refer to the bulletin of February 2015, Update: Medicare Advantage Program Coding for Annual Wellness Visits .
NOTE: Our plans do not cover routine physical examinations typically billed using the Preventive Medicine Services procedure codes 99381 – 99397. Effective for services performed on and after January 1, 2016, all visits billed with these procedure codes for Medicare Advantage members will be denied.
Remember to check member eligibility and benefits electronically through Availity
Stay up-to date with the latest Medicare preventive services news for Medicare beneficiaries by logging in to the CMS website at http://www.cms.gov/ and selecting the Outreach and Education tab.
Learn Medical Billing Process, Tips to best AR Specialist. Medical Insurance Billing codes, Denial, procedure code and ICD 10, coverage guidelines. Demographic, charge, payment entry, AR process and eligibility and follow up. How to Guide.
Pages
- Home
- Medical Billing Question and Answer - Terms
- Insurance Denial Claim Appeal Guidelines.
- Medical Billing Downloads
- Understand Medical Billing
- Medical Billing Outsource
- Medicare Coverage and Plan Overview
- Advertise with us
- EVALUATION AND MANAGEMENT CPT code [99201-99499] - Full List
- Overall Medical billing process
- CPT Code 99201, 99202, 99203, 99204, 99205 - Which code to USE
- Internal Medical Billing Audit - how to do

Subscribe to:
Post Comments (Atom)
Medical Billing Popular Articles
-
CPT CODE AND Description 99391 - Periodic comprehensive preventive medicine reevaluation and management of an individual including an age...
-
Procedure CODES and Descriptions 99401 - Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an indi...
-
CPT Code and description 99381 - Initial comprehensive preventive medicine evaluation and management of an individual including an age an...
-
Procedure code and Description 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A pro...
-
CPT code and description 80050 - General health panel This panel must include the following: Comprehensive metabolic panel (80053), ...
-
Billed amount: It is the Amount charged for each service performed by the provider. In other words it is the total charge value of the cla...
-
93000-93010: Hone Your ECG Coding Skills With 3 Essential Pointers Whether you call them ECGs or EKGs, chances are you see a lot of elec...
-
When an ERA is received, providers may: •Post decision and payment information automatically, for individual claims included in an R...
-
Medicare denial code and Descripiton 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent ...
-
Background: Type of Service (TOS) is an indicator that the contractor places on the Form CMS-1500 paper form or electronic format. The indic...

No comments:
Post a Comment