How to code Annual wellness visit for Medicare and commercial insurance

For Medicare, annual wellness visits will be paid with following codes

G0402:  Initial Preventive Physical Examination; face-to-face visit, services limited to a new patient during the first 12 months of Medicare enrollment. (welcome to Medicare; one time benefit)

G0438: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

G0439: Annual wellness visit; includes a personalized prevention plan of service (pps), subsequent visit


For Commercial insurance, use 99381---99397

New billing guidelines for Prolonged services 99358, 99359

Prolonged services 2017 guidelines

CPT codes 99358 and 99359 (prolonged services without face-to-face contact) will be separately payable by Jan 1st, 2017 and they will not be included for payment under the related face-to-face Evaluation and Management (E/M) service code.


Additional Information

https://www. cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3678CP.pdf.

Fluoroscopic guidance codes 77002, 77003

2017 Revision of Fluoroscopic guidance codes 77002, 77003

77002 needle placement (eg, biopsy, aspiration, injection, localization device) and 77003 (spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) will be included in global surgery period by Jan 1st, 2017 and will not be used as stand alone codes.

Replacement of code G0389 Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

As of Jan 1st, 2017, Medicare will not accept CPT code G0389 Ultrasound Screening for Abdominal Aortic Aneurysm (AAA).

G0389 has been replaced with CPT 76706 Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)


Reference:

https://www.cms.gov/RegulationsandGuidance/Guidance/Transmittals/Downloads/R3669CP.pdf.