What are AWV codes?
Asked by: Dr. Peyton Abernathy | Last update: May 25, 2025Score: 4.3/5 (3 votes)
What are the wellness CPT codes?
At ChartSpan, we provide eligibility checks for G0438 and G0439 — the core codes for Annual Wellness Visits. However, some AWVs may involve additional codes depending on a patient's needs.
What is AWV for Medicaid?
The Centers for Medicare & Medicaid Services established the Annual Wellness Visit (AWV) to keep Traditional Medicare patients healthy and promote preventive care. AWVs are conducted yearly with a health professional to identify and reduce health risks and create or update a patient's personalized prevention plan.
What is the difference between AWV and annual physical?
While a physical includes a full examination and a wellness evaluation, an Annual Wellness Visits focuses solely on a patient's answers to a health risk assessment. It does not typically include any lab work or tests requiring physical contact.
What type of code is G0439?
HCPCS G0439 is used to code all subsequent Medicare annual wellness visits that occur after the initial AWV (G0438).
What are Medicare's Rules and Requirements for Annual Wellness Visits (AWV)?
What are possible AWV codes?
AWV Coding. The CPT codes for Annual Wellness Visits are G0438 for the initial visit and G0439 for subsequent visits. These codes are used to bill Medicare for comprehensive wellness assessments and personalized prevention plans. It is important to remember that code G0438 is for the first AWV only.
What are the three types of Medicare wellness visits?
- Initial Preventive Physical Exam (IPPE)
- Initial Annual Wellness Visit (AWV)
- Subsequent AWVs.
What is not covered in a Medicare annual wellness visit?
Medicare does not cover Annual Wellness Visits if they are used to discuss, plan, or alter treatment for pre-diagnosed chronic illnesses, including high cholesterol, high blood pressure, or arthritis.
What are the three words to remember for a Medicare wellness exam?
Word recollection (Banana, Sunrise, Chair) Have patient repeat the 3 words, tell them to remember them.
Can I bill an office visit with an AWV?
When you provide an AWV and a significant, separately identifiable, medically necessary evaluation and management (E/M) service, we may pay for the additional service. Report the additional CPT code (99202–99205, 99211–99215) with modifier 25.
Can an RN perform an AWV?
AWVs can be completed by a provider (i.e., a physician or non-physician practitioner (NPP)), registered nurses (RNs), or other medical professionals (e.g., health educator, registered dietitian) working under direct supervision of a physician or NPP.
Is bloodwork part of a wellness visit?
Does a Wellness Exam Include Blood Work? Yes, a wellness exam can include blood work. However, it's important to note that the specific tests conducted during a wellness exam may vary from person to person.
What is the AWV regulation?
What is the foreign payments reporting obligation? Under Germany's Foreign Trade and Payments Ordinance (“Außenwirtschaftsverordnung” or “AWV”), businesses and private individuals must report international money transfers involving amounts greater than 12,500 euros.
Does an AWV have to be 12 months apart?
Medicare provides coverage of an Annual Wellness Visit (AWV) for a beneficiary who is no longer within 12 months after the effective date of his or her first Medicare Part B coverage period and who has not received either an Initial Preventive Physical Exam (IPPE) or an AWV within the past 12 months.
What is the 33 modifier used for?
Current Procedural Terminology (CPT) modifier 33 can be used when billing for ACA-designated preventive services with a commercial payer. The addition of modifier 33 communicates to a commercial payer that a given service was provided as an ACA preventive service.
What is the diagnosis code for AWV?
2024 CPT Codes for Medicare Annual Wellness Visit: G0402, G0438, G0439. A Medicare Annual Wellness Visit (AWV) is a preventive screening used to identify gaps in care. As covered by Medicare Part B, providers should understand what CPT billing codes matter to the service and how to use them.
Can I refuse the Medicare annual wellness visit?
People can refuse a Medicare annual wellness visit, but it is worth considering the potential benefits. Wellness visits can help healthcare professionals detect health issues early on and are an important part of preventive care.
What is the difference between a wellness exam and an annual exam?
An annual physical exam is more extensive than an AWV. It involves a physical exam by a doctor and includes bloodwork and other tests. The annual wellness visit will just include checking routine measurements such as height, weight, and blood pressure.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
Are labs included in a Medicare annual wellness visit?
The AWV does not include routine blood tests; however, to save you time and offer more comprehensive care, your provider may combine the AWV with your routine follow-up visit and may request blood tests. Lab tests are covered under your Medicare benefits based on the medical diagnosis associated with the orders.
What is not included in a wellness exam?
Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit. The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care.
Is a breast exam part of a Medicare wellness visit?
Medicare covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer.
Can you bill an office visit with an annual wellness visit?
CPT states that if a new or existing problem is assessed and managed at the time of the preventive visit, the physician should also bill a problem-oriented visit (an office visit) on the day of the preventive care. But insignificant problems that do not require extra work should not be billed as office visits.
Is an EKG included in the welcome to Medicare visit?
Electrocardiogram (EKG or ECG) screenings
Part B covers an EKG or ECG (as a one-time screening with a referral from your doctor as part of your "Welcome to Medicare" preventive visit and as a diagnostic test.)...