e-AWV®: Frequently Asked Questions
Your Medicare AWV….answers
Will the e-AWV system work with my EMR?
Our system works with both electronic and paper medical records. The e-AWV™ will either save a .pdf file which can then be uploaded to your EMR or print a summary for the paper medical record. It is not necessary to have access to an EMR during the Annual Wellness Visit.
What must I document in my EMR for an Annual Wellness Visit?
Because the AWV is not a diagnostic visit, there usually is no need to add new medical information to the EMR. 99% of all AWV’s should be performed on patients with an established medical record, therefore, the EMR is just used to review the previously documented medical history for your patient. The e-AWV allows you to upload a .pdf file to your EMR with a summary of the AWV.
How do I bill for Annual Wellness visits?
G0438 – Used for the first Annual Wellness Visit for that patient (once in a lifetime code)
G0439 – Used for all susbsequent Annual Wellness Visits.
What diagnosis code do I use with AWV’s?
When billing for G0438 or G0439, you can use ICD-10 code Z00.8 as the diagnosis code. You can also use any current diagnosis code for the patient as well.
How often can I perform Annual Wellness Visits?
Medicare states that they will not pay for an AWV that is performed less than 11 months since the previous Annual Wellness Visit or the Welcome to Medicare (IPPE) Exam.
When do I perform Annual Wellness Visits?
During the first 12 months a patient is on Medicare, they will receive the Welcome to Medicare exam (IPPE) instead of the Annual Wellness Visit. They then become eligible for their initial Annual Wellness Visit 11 months after the IPPE. If they did not receive an IPPE during the first 12 months, they are eligible for their initial AWV after they have had Medicare for 12 months. From then on, every Medicare patient can receive their Annual Wellness Visit 11 months after their previous AWV. The IPPE has specific requirements that must be met, do not confuse the IPPE with the AWV.
Can I use the e-AWV to perform the Welcome to Medicare Exam (IPPE)?
Yes, the e-AWV™ and the AWV Portfolio™ can be used as part of the IPPE, however you still must meet all the additional IPPE requirements in order to be reimbursed.
Why should I offer Annual Wellness Visits to my patients?
1. It is one of the few services that Medicare WANTS to pay for.
2. It is one of the highest paid visits that can be performed in a physicians office.
3. It can be performed by staff rather than the physician and still be reimbursed in full.
4. It improves patient satisfaction and their ability to care for themselves.
5. It helps patients take responsibility for their own health.
Who can perform the Annual Wellness Visits?
- A physician, PA or NP can perform the AWV at any time at any location.
- In addition, Medicare states that the AWV can also be performed by a licensed medical professional (such as an RN or LPN) or a team of professionals such as Registered dietitians, pharmacists, physical therapists, etc. under the “direct supervision” of a physician.
- Many practices find it beneficial to designate or hire an RN or LPN specifically to handle all AWV’s. They can operate somewhat independently of the rest of the office, with the only limitation being that the physician must be available for immediate consultation in the unlikely event it becomes necessary.
- Some practices use medical assistants to obtain and review the required information with the patient, then complete the AWV with a short consultation with the physician, PA or NP.
What equipment is necessary to perform the AWV?
A computer or tablet with internet access, BP cuff, stethoscope, thermometer, weight scale, height chart. The AWV is best performed in a comfortable office environment rather than an exam room.
Should I perform the AWV on patients who are ill?
According to Medicare, the AWV is designed for well patients. If a patient is ill or wants diagnostic services performed, it is best to reschedule the AWV for a later time and perform a regular diagnostic visit.
Does the e-AWV include a Health Risk Assessment (HRA)?
Yes, the e-AWV™ includes a Health Risk Assessment. If you desire, we also have a patient questionnaire that can be mailed to the patient about 2 weeks prior to the visit. For efficiency, this form corresponds directly with the HRA that is done by the medical professional during the visit.
What should the patient bring with them to their visit?
1. The completed Patient Questionnaire that was mailed two weeks before their visit. (if used by practice)
2. All medications (in bottles) they are currently taking (OTC and Rx)
3. Immunization Records if they have any
Can other services be provided at the same time of the AWV?
This may vary depending on your MAC jurisdiction. Billing for these services is typically done using a modifier -25. Your billing company should have specific details for your area. You must be very careful not to duplicate your documentation for additional services. This is one advantage of the e-AWV, because all documentation for the AWV is kept separate from documentation for other services provided.
Am I required to do a full Cognitive Screening during the AWV?
You are required to offer a simple cognitive screening (such as the one included in our system) but you do NOT have to do a comprehensive screening during the AWV. The AWV is only to determine if additional in-depth screening is needed.
“We have used the e-AWV on almost 300 patients. It is so much easier than a paper template, and guides my staff through the entire process. I wish EMR’s were this simple. Our patients are happy to receive a full personal health record at the end of the e-AWV and feel they have a better understanding of their health. We have increased our Medicare reimbursement while giving better care to our patients.”Dr. Graham Jones, MD