IPPE/AWV Visits (CPT Codes: G0402, G0438, G0439)

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fjohnson
Posts: 59
Joined: Wed Mar 13, 2013 9:04 am

Mon Aug 06, 2018 3:47 pm

If documentation does not support IPPE/AWV Visits, does anyone change code to the appropriate (meaning based on review of supporting documentation) E/M code?

Please send regulatory guidance to support this if applicable.
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admin
Site Admin
Posts: 431
Joined: Mon Apr 09, 2012 1:54 pm

Tue Aug 07, 2018 1:19 pm

Hi there,

This is a grey area that is more about ethics then guidance. There is nothing that supports if an AWV/IPPE was billed, that cannot be supported, can or can't be crossed to a crossed over to a problem visit. The real problem is if the patient is expecting the service to have no copay, no expense, is it "right" to bill them for the problem visit encounter. It is not the patient's fault that the documentation did not capture all the required elements, that is on the clinic to have it capture everything.

Unfortunately, there is no real guidance that I know of that says one way or the other. If you have any more questions, please let us know.

Your question has been answered by Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC
fjohnson
Posts: 59
Joined: Wed Mar 13, 2013 9:04 am

Mon Aug 20, 2018 1:32 pm

Thank you for this response. I had not thought about the financial impact.
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