Get Rowan Medicine Medicare Annual Wellness Visit Process – Front Desk Staff

Q - Is the IPPE the same as the initial AWV? A - No, the IPPE is the Initial Preventive Physical Examination, also known as the "Welcome to Medicare" visit (G0402), while the initial AWV (G0438) is the patient's first Medicare AWV following the IPPE.

What Is G0438? G0438 is the HCPCS code you should use when coding a patient's first annual wellness visit. Its long descriptor is "Annual wellness visit, includes a personalized prevention plan of service (PPPS), first visit," while its short descriptor is "Annual wellness first."

HCPCS G0439 is used to code all subsequent Medicare annual wellness visits that occur after the initial AWV (G0438). So, if used correctly, G0439 would not be used until G0402 was used to code the IPPE and G0438 was used to code the initial AWV.

That portion of the visit must be medically necessary and reasonable to treat the patient's illness or injury or to improve the functioning of a malformed body part. You can only bill G0438 or G0439 once in a 12-month period. G0438 is for the first AWV and G0439 is for subsequent AWVs.

HCPCS code G0438 is used to reimburse healthcare providers for a patient's first annual wellness visit, provided that the patient has been enrolled in Medicare Part B for more than 12 months and has not received another AWV or initial preventive physical exam (IPPE) in the prior 12 months.

The initial AWV, G0438, is performed on patients that have been enrolled with Medicare for more than one year. A patient is eligible for his subsequent AWV, G0439, one year after his initial visit.

An initial Annual Wellness Visit code is documented using G0438, subsequent Annual Wellness Visits are documented using code G0439.

HCPCS G0439 is used to code all subsequent Medicare annual wellness visits that occur after the initial AWV (G0438). So, if used correctly, G0439 would not be used until G0402 was used to code the IPPE and G0438 was used to code the initial AWV.