Medical Coding Rights

 HCPCS/CPT Codes G0438 – Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit G0439 – Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit Who Is Covered All Medicare beneficiaries who are both, Not within 12 months after the effective date of their first Medicare Part B coverage period Have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months Frequently Used ICD Z00.00 - Encounter for general adult medical examination without abnormal findings Z00.01 - Encounter for general adult medical examination with abnormal findings Z00.121 - Encounter for routine child health examination with abnormal findings Z00.129 - Encounter for routine child health examination without abnormal findings Frequency Once in a lifetime for G0438 (first AWV) Annually for G0439 (subsequent AWV) Medicare Beneficiary Pays Copayment/coinsurance waived Deductible waived

Preventive Service Codes The annual preventive exam is a periodic, comprehensive preventive medicine evaluation (or reevaluation) and management of the patient. The CPT Code selection is based on whether the patient is receiving an initial visit -"New Patient" or a periodic - "Established Patient" preventive service, as well as the patient’s age. Initial Visits - 99381, 99382, 99383, 99384, 99385, 99386, 99387 Subsequent Visits - 99391, 99392, 99393, 99394, 99395, 99396, 99397 The Medicare insurance would be covered by "G" codes instead of the above codes. The details below, Welcome to Medicare - G0402 (Within the one year from the patient enrolled in Medicare) Initial Annual Wellness Visit - G0438 (After the 1st year of enrollment) Subsequent Annual Wellness Visit - G0439 Initial Visits Initial comprehensive preventive medicine evaluation and management of an individual including an" age and gender appropriate history, examination, counseling/anticip