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Welcome to this video slideshow presentation from the Medicare
Preventive Services National Provider Call on the Initial Preventive
Physical Exam and the Annual Wellness Visit. This educational call was
hosted by the CMS Provider Communications group within the Center for
Medicare on Wednesday, March 28, 2012.
I am Leah Nguyen from the Provider Communications Group here at CMS, and
I will serve as your moderator today. I would like to welcome you to
this Medicare Preventive Services National Provider Call on the Initial
Preventive Physical Exam and the Annual Wellness Visit.
During this National Provider Call, CMS subject matter experts will
provide an overview of both services: when to perform them, who can
perform them, who is eligible, and how to code and bill for each
service. A question and answer session will follow the presentation.
Before we get started, I have a few announcements. This call is being
recorded and transcribed. The audio recording and written transcript
will be posted soon to the National Provider Calls and Events section of
the Fee-For-Service National Provider Calls webpage.
There is a slide presentation for this session. If youve not already
downloaded this presentation, you may do so now by going to the
Fee-For-Service National Provider Calls webpage at www.cms.gov/npc.
Again, that URL is www.cms.gov/npc. At the left side of the webpage,
select National Provider Calls and Events then select the March 28
call from the list.
Please be aware that Continuing Education Credits may be awarded by the
American Academy of Professional Coders, the American Health Information
Management Association, and the American Medical Billing Association for
participation in CMS National Provider Calls.
Please see slide 52 of the presentation for more information. If you
have any questions regarding the awarding of credits for this call,
please contact that organization. We encourage you to retain your
presentation materials and confirmation e-mails.
I would also like to thank those of you who submitted questions when you
registered for todays call. Your questions were shared with the
speakers to help prepare the slides and remarks for todays
presentation.
Please note that although we may not be able to address every question
submitted during registration, will we we will review them to help us
develop Frequently Asked Questions, educational products, or future
messaging on these programs.
At this time, I would like to introduce our speakers who are subject
matter experts on todays topic.
We are pleased to have with us Jamie Hermansen from the Office of
Clinical Standards and Quality, Coverage and Analysis Group; Kathleen
Kersell from the Center for Medicare, Provider Billing Group; Stephanie
Frilling from the Center for Medicare, Hospital Ambulatory Policy Group;
and Thomas Dorsey from the Center for Medicare, Provider Billing Group.
So now, it is my pleasure to turn the call over to our first speaker,
Jamie Hermansen from the Office of Clinical Standards and Quality at
CMS. Thank you, Leah. Id like to begin by providing some background
information on the coverage for the IPPE, or the Initial Preventive
Physical Examination.
Medicare coverage Medicare Part B coverage of the IPPE was authorized
by the Medicare Prescription Drug Improvement and Modernization Act of
2003 and later modified by the Medicare Improvements for Patients and
Providers Act of 2008, and implementing regulations for the IPPE are
can be found at 42 CFR, 410.16.
Regarding beneficiary eligibility and frequency, the IPPE is a one-time
visit and is covered for beneficiaries within the first 12 months of
Medicare Part B enrollment.
The IPPE is covered by Medicare Part B and furnished by a physician,
physician assistant, nurse practitioner, or clinical nurse specialist.
And Id now like to hand the call over to Stephanie Frilling.
Thank you, Jamie.
Im Stephanie Frilling from the division of Practitioner Services in
HAPG, and Jamie has asked me to address this slide as many questions
requested from the registration page on incidents to billing and
furnishing IPPE or the AWV.
From the collected questions, we know that many of you are very familiar
with Medicare policies for billing and payment of incidents to services.
However, the payment policy, furnishing services incident to a
physician do not apply to the IPPE as this service has its own benefit
category.
Slide eight is an overview of incident to billing rules that are
recognized when services or supplies are furnished, incident to a
physicians order.
In many cases, a nurse or other healthcare provider will furnish
services where payment is commonly captured on the physicians claim.
No separate Medicare claim is made to the non-physician provider.
The IPPE is not subject to incidents to billing and payment rules under
Section 1861(s)(2)(a) of Social Security Act as the IPPE has its own
benefit category established under Section 1861(ww) of the Act, and must
meet the statutory requirements set forth in this Section of the Act.
Physicians and practitioners must meet specific benefit requirements for
who may furnish an IPPE in order to bill for this service.
Jamie, thank you.
Thank you, Stephanie.
Moving on to slide nine, the following elements are included in the
IPPE: a review of medical in summary, its the review of medical and
social history, the reviews of potential risk factors for depression;
functional ability and level of safety; measurement of height, weight,
body mass index, blood pressure, and visual acuity screen, and other
factors deemed appropriate.
Discussion of it also includes the discussion of end-of-life planning
upon agreement of the individual; along with education, counseling, and
referrals based on results of review and evaluation of services
performed during the IPPE, which also includes a brief written plan such
as a checklist, and if appropriate, education counseling and referral
for obtaining an electrocardiogram, also referred to as an EKG.
I will now hand the call over to Kathleen Kersell.
Hi. Thank you, Jamie.
If youre following along, were on slide 10 and for the IPPE, slide 10,
it gives you instructions on how to code for this service.
You would use Code G0402 to report the IPPE on your claim. The various
components of the IPPE previously described on slide nine must be
provided and documented in a beneficiary in a beneficiarys medical
record during the IPPE.
The people that can bill the IPPE are typically well, sorry. Next
question would be Who can bill for the IPPE?
These services are typically provided in a physicians office. When
the services are provided in a facility, the following institutions can
bill: Hospitals for Inpatients on Type of Bill 12X and Outpatients, Type
of Bill 13X; Skilled Nursing Facilities for inpatients, Type of Bill
22X; and Rural Health Centers, Type of Bill 71X; Federally Qualified
Health Centers, Type of Bill 77X; and Critical Access Hospitals, Type of
Bill 85X.
On slide 11, you just got diagnosis coding for the IPPE. Although a
diagnosis code must be reported on the claim, there is no specific
International Classification of Diseases, 9th Revision, Clinical
Modification or ICD-9-CM diagnosis codes that are required for the IPPE.
Medicare providers should choose an appropriate ICD-9-CM diagnosis code.
Examples for diagnosis code that could be included on the claim are
V70.0, V70.3, or V70.9. They all could be considered acceptable
diagnosis codes, as well as any other valid, appropriate diagnosis code.
You can also contact your Medicare contractor for any assistance with
what type of diagnosis codes you want to have on the claim.
I also do want to point out that on slide 11, where Im at right now, I
said V70.3. That slide says V70.8 and we will be posting a corrected
slide that says V70.3 and I do apologize for that error. But
basically, any appropriate diagnosis code would be acceptable for
billing an IPPE.
Now on slide 12, discussed frequency, How often can the IPPE and the
screening EKG be performed?
The IPPE, code G0402, is a one-time benefit that must be provided within
12 months of the effective date of a beneficiarys Medicare Part B
coverage. The screening EKG, which is codes G0403, G0404, or G0405, as
appropriate, can be done when they are done as a referral from an IPPE.
Its also only covered once during a beneficiarys lifetime.
On slide 13 is the frequency of the EKG the screening EKG for an IPPE
and diagnostic EKG performed on the same day. A diagnostic EKG cannot
be performed on the same day as the screening EKG for the IPPE unless it
is medically necessary.
If a diagnostic EKG is performed on the same day as codes G0403, G0404,
or G0405 and is deemed medically necessary, then the diagnostic EKG must
be billed with Modifier 59. Otherwise, a diagnostic EKG cannot be done
on the same day as a screening EKG.
Slide 14 about deductible and coinsurance for the IPPE, effective for
dates of service on or after January 1st, 2011, the coinsurance and the
deductible are waived for the IPPE for code G0402 only.
However, the deductible and coinsurance still apply to the screening EKG
that can be done as a referral from an IPPE; therefore, codes G0403,
G0404, and G0405 still have to have the deductible and coinsurance
applied to them.
Next, slide 15 is for the IPPE-related screening for Abdominal Aortic
Aneurysm. If you have an IPPE done, you can also provide for the
beneficiaries a one-time only ultrasound screening for an Abdominal
Aortic Aneurysm, or AAA, you know, that can be done as the result from
an IPPE with certain you know, if the beneficiary has certain risk
factors.
The codes for billing the AAA ultrasound screening is G0389 and thats
an Ultrasound, B-scan, and/or real time with image documentation, AAA
screening.
Slide 16, more on the IPPE-related screening of effective for dates of
service on or after January 1st, 2011, the coinsurance and deductible
are waived for the AAA screening, code G0389.
For more information on the AAA screening when done as the result of a
referral from an IPPE, please see the CMS Internet-Only Manual
Publication 100-04, Chapter 18, Section 110 on the CMS Web site. That
CMS Web site is www.cms.gov/manuals/downloads/clm104c18.pdf.
Also, that manual section will give you all the requirements needed for
beneficiary you know, that a beneficiary must meet in order to be
eligible to receive the AAA ultrasound screening.
Now from that, were moving on to Ill turn this over to Stephanie
Frilling on slide 17. Thank you.
Thank you, Kathy, and again, this is Stephanie Frilling from the
Division of Practitioner Services and Ill begin my presentation on
slide 17.
We are very pleased to announce that twice as many IPP Exams were
furnished in 2011 than in 2010. This is largely credited to Section
4104 of the Affordable Care Act where Congress waived cost sharing
requirements for IPPE services furnished on or after January 1st, 2011.
Now, when a beneficiary receives an IPP Exam from a provider who accepts
assignment, they will pay nothing for the visit.
In 2011, 235,000 beneficiaries, all within the first 12 months of Part B
coverage, received the IPPE Physical Examination, providing an ongoing
systematic foundation for wellness and prevention.
On slide 18, many questions were collected from the registration page
regarding the IPPE service elements and those of a traditional annual
physical examination. Medicare does not provide coverage for routine
physical examinations and the IPPE is a preventive wellness examination
and not the head-to-toe physical examination.
While there is some overlap, for example, the IPPE identifies health
risk health risk factors and takes routine measurements and updates
the beneficiarys medical record, the focus of the IPPE is to furnish
education counseling and prevention services that are appropriate for
the individuals and available in Medicare.
During our last call in July of 2011, we received many questions from
practitioners seeking advice on how to manage a patients perception of
an IPPE. Many practitioners indicated that beneficiaries were often
expecting a routine annual checkup, and were confused when so much of a
practitioners time was dedicated to preventive counseling and
education.
We have furnished much guidance on this issue over the last several
months and many materials are available on the CMS Web site. And they
can be reviewed at www.cms.gov/preventiongeneralinfo.
In particular, Id like to mention the preventive screening checklist
that you can give to your patients and where a physician and a patient
can discuss and actually track preventive services available for the
beneficiary.
Moving on, on slide 19, the best time to schedule an IPPE Exam for a
patient is of course within the first 12 months of their Part B
coverage, but also, when a beneficiarys health status is stable and the
patient is open to discussing preventive and screening services
available in Medicare.
Furthermore, in order to maximize the face-to-face time of the IPPE
Exam, the patient should come prepared and ready to discuss their
medical history, current treatment, medications, and to discuss and
develop a preventive screening schedule.
While we believe that the IPPE is best furnished when a beneficiarys
health status is stable, we recognize that some patients with a chronic
or diagnostic condition present during the IPPE may require additional
medically necessary Evaluation and Management Services.
On slide 20, we note that when an E and M service in the code range of
not of CPT code 99201 through 99215 are furnished during an IPPE
visit, the practitioner must append Modifier 25 to the claim line for
payment.
Cost sharing will apply to the E/M service that is furnished during the
IPP Exam as the Affordable Care Act only waives the cost sharing
requirement for the IPPE and not the E and M service.
While other preventive services, screenings and laboratory tests are not
included in the IPPE, they may be furnished during the visit if they are
appropriate for the individual. No modifier is required for billing
other preventive services when furnished during the IPP Exam.
As a special note, Section 4104 of the Affordable Care Act also waives
cost sharing for many preventive services. And the IPPE is a great
opportunity to furnish or order preventive laboratory tests or get a flu
shot.
On slide 23, once again from the registration page, many questions came
around billing Medicare non-covered preventive physical examinations
with an IPP Exam.
Non-covered preventive services including E and M services may be billed
with an IPPE. However, we would hope that the provider would notify the
patient that the additional services are non-covered by Medicare and
that the payment for the additional non-covered preventive service will
fall to the beneficiary.
We further note that non-covered E and M preventive services will have a
substantial overlap in the service elements furnished at the IPPE, and
that practitioners are responsible for billing appropriately when
providing additional non-covered E/M preventive services.
We suggest that providers use some documentation, such as an ABN, to
notify the patient that payment for the additional non-covered
preventive service is not covered by Medicare.
On slide 24, we have posted the 2012 National Payment Rates for the
Non-facility and for the Facility Payments for furnishing an IPPE. The
link referenced from the slide is for the Physician Fee Schedule Look up
Tool where a practitioner can look up the payment rate for a specific
locality.
For those of you not familiar with the Look Up Tool, I encourage you to
go to the site and give it a try, as payment rates for most physician
services are available on the Look Up Tool. Now, well go back to Jamie
Hermansen as we move into our next section on the Annual Wellness Visit.
Thank you, Leah.
By way of background, Medicare coverage for the Annual Wellness Visit
was authorized by the Affordable Care Act of 2010, and implementing
regulations were established at 42 CFR 410.15.
Coverage of the AWV became effective on January 1st, 2011, while the
Affordable Care Act specified the provision of personalized prevention
plan servicesinclude and take into account the results of a health
risk assessment, the statute also provided the secretary with additional
time to develop guidance on health risk assessment.
As a result in the calendar year 2012 Physician Fee Schedule rule, we
modified the AWV regulations to include the health risk assessment in
the provision of supplies prevention plan services as part of the Annual
Wellness Visit.
Moving on to slide 28 regarding beneficiary eligibility and frequency, a
beneficiary is eligible to receive an Annual Wellness Visit if they have
had Medicare Part B for longer than 12 months or 12 months after
receiving their IPPE.
Now, we note that the beneficiary does not need to receive an IPPE to be
eligible for an Annual Wellness Visit. And regarding frequency, the AWV
is covered once every 12 months.
For slide 29 we discussed who can furnish an Annual Wellness Visit,
which is which we defined as a health professional which means a
physician, physician assistant, nurse practitioner, clinical nurse
specialist; or a medical professional including a health educator, a
registered dietitian, nutrition professional, or other licensed
practitioner; or a team of special medical professionals working under
the direct supervision of a physician.
As weve discussed in the preamble to the Calendar Year 2011 Physician
Fee Schedule Rule, we are not assigning particular tasks or restrictions
for specific members of the team, and we believe its better for
supervising physicians to assign specific tasks to qualified team
members as long as they are licensed in the state and working in their
states group of practice. And, we also believe that this approach gives
the physicians and the team the flexibility needed to address the
beneficiarys particular needs on a particular day.
So I will now hand the call over to Stephanie Frilling.
Thanks, Jamie.
Id like to confirm that like the IPPE, the AWV is not subject to
incident to rules. And where the wellness visit is performed by a team
of medical professionals working under the supervision of the physician,
it is the supervising physician who will bill Medicare for the visit.
Also, in response to questions collected up from the registration page,
I would like to take this moment to clarify that direct supervision in
the office setting means that a physician must be present in the office
suite and immediately available to furnish assistance and direction
throughout the performance of the procedure or service.
Thank you, Stephanie. And moving on to slide 31, the Annual Wellness
Visit is the visit that focus that focuses on prevention wellness and
the provision of personalized prevention plan services.
And in summary, the first annual wellness visit includes the following
elements: A health risk assessment, which we will provide more
information about shortly.
The establishment of an individuals medical and family history;
establishment of a list of current providers and suppliers that are
regularly involved in providing care to the beneficiary; measurement of
blood pressure, height, weight, or waist circumference, if appropriate.
Detection of any cognitive impairment; and review of potential risk
factors for depression, functional ability and level of safety; and the
establishment of a written screening schedule such as a checklist for
the next 5 to 10 years; a list of the risk factors and conditions where
interventions are recommended; and finally the furnishing of
personalized health advice and referrals for health education and
preventive counseling.
Moving on to slide 32, in general, the subsequent Annual Wellness Visit
you can see on that slide, the list of a summary list of the
elements. Its mostly focused on updating the information that was
provided during the first Annual Wellness Visit or the most recent for
yousubsequent visit, whichever visit theyve most recently had. So, it
has a similar look to the elements there.
Moving on to slide 33 which is focusing on changes for 2012, as I
mentioned earlier, we modified the Annual Wellness Visit regulations to
include and take into account the results of a health risk assessment,
which in summary, collects self-reported information known to the
beneficiary; which can be administered by a beneficiary or a health
professional before or as part of the Annual Wellness Visit encounter;
and take no more than 20 minutes to complete.
On slide 34, in summary, the health risk assessment addresses the
following topics: demographic data, self assessment of health status,
psychosocial risks, behavioral risks, activities of daily living, and
instrumental activities of daily living.
Wed also like to point out that the Centers for Disease Control and
Prevention, it published an article entitled A Framework for Patient
Centered Health Risk Assessment. And, this framework this framework
includes information on the use of health of HRAs and follow-up
interventions that others have suggested that in that can influence
health behaviors.
Defining the HRA framework rationale for its use, the history of health
risk assessment and risk-adjusted set of HRA questions, which can be
found in the in Appendix A of that of that publication. You can
find a link to this publication on slide 50 of this presentation packet.
And finally, moving on to slide 35, in preparation for the Annual
Wellness Visit, were encouraging beneficiaries to bring the following
information with them to their appointment: any pertinent medical
records; family health history; a list of medications and supplements,
including calcium and vitamins that they may be taking; and a list of
current providers and suppliers involved in their health care.
Id like would now like to hand the call over to Thomas Dorsey. Thank
you, Jamie.
My first slide, 36, concerns the required billing procedure codes that
can be billed for each service. Two G-codes are used to identify the
Annual Wellness Visit for purposes of Medicare payment: G0438 Annual
Wellness Visit, including Personalized Prevention Plan Service, first
visit; and G0439 Annual Wellness Visit, including the Personalized
Prevention Plan Service, subsequent visit.
Now, who can bill for the Annual Wellness Visit? These services are
typically provided in a physicians office. However, the services can
be provided in a facility.
When the services are provided in a facility, the following institutions
can bill: Hospital Inpatients Type of Bill 12X, and Outpatients Type
of Bill 13X; Skilled Nursing Facilities Inpatients Type of Bill 22X,
and Outpatients 23X; Rural Health Centers Type of Bill 71X; Federally
Qualified Health Centers Type of Bill 77X; and Critical Access
Hospitals Type of Bill 85X.
The next slide, 37, concerns diagnosis coding. Medicare claims must
follow diagnosis code on the claim. However, although a diagnosis code
must be included on the claim, there are no specific International
Classification of Diseases named provision, Clinical Modification,
ICD-9-CM diagnosis codes that are required for the Annual Wellness
Visit.
Therefore, a Medicare provider should choose an appropriate ICD-9-CM
diagnosis code or contact the local Medicare contractor for guidance.
A number of providers have been submitting Annual Wellness Visit claims
with diagnosis code 70.0, routine general medical examination at a
healthcare facility, and this code is being accepted.
Other examples are V70.3 to V70.9. As a note, the slide will be changed
to show V70.3 instead of V70.8.
My next slide, slide 38, addresses frequency of services. The first
Annual Wellness Visit can be billed only once in a lifetime using code
G0438. The subsequent Annual Wellness Visit, G0439, can be billed
annually provided that 11 full months have passed since the last Annual
Wellness Visit.
Slide 39, frequency of EKG, points out that Medicare providers may
perform a medically necessary diagnostic EKG on the same day that an
Annual Wellness Visit G0438 or G0439 is performed. In the pay out, some
claims for diagnostic EKGs performed on the same day as the Annual
Wellness Visit have been denied.
CMS has made claims processing changes to allow payment for a
diagnostic, medically necessary EKG performed on the same day as an
Annual Wellness Visit. Providers that may have been denied a claim for a
medically necessary diagnostic EKG performed because it was performed on
the same day as an Annual Wellness Visit may contact their Medicare
claims processing contractor and request after April 1, 2012 that their
denied claim be adjusted for payment.
On to my last slide, slide 40, this points out that from the Annual
Wellness Visit, the annual Medicare Part B deductible is waived as is
the normal coinsurance.
This slide also points out that the Annual Wellness Visit is effective
for services on or after January 1, 2011. And now, I will return the
presentation over to my colleague, Stephanie Frilling.
Thanks, Tom. And I will begin on slide 41 with AWV utilization. Im
pleased to announce that 2,599,512 AWV visits were furnished in 2011,
the first year of this visit.
So in all cases, the first annual visit recognized by G0438 was billed.
For the first two months of 2012, 319,106 first Annual Wellness Visits
were furnished to beneficiaries and 92,285 subsequent visits recognized
by G0439 were furnished to the beneficiaries.
We are encouraged by these results.
On slide 42, like the IPPEs, the AWV is a face-to-face preventive visit
for beneficiaries and not a head-to-toe physical examination. The
Annual Wellness Visit includes a personalized prevention plan of service
known in Medicare as the PPPS. Section 4103 of the Affordable Care Act
specifically intended this visit to furnish personalized health advice,
referrals as appropriate to health education, preventative counseling
services or programs aimed at reducing identified risk factors and
promoting self management and wellness.
The AWV, like the IPPE, is best furnished to a beneficiary when their
health status is stable and they are open to discussing preventive and
screening services available on Medicare. We ask providers to be
thoughtful regarding the best timing of the AWV to maximize its impact
on a beneficiarys health.
A provider shall encourage beneficiaries to complete the HRA prior to
the visit so that the patient and the provider can maximize the
face-to-face time and allow the preventive follow up where health risks
are continuously monitored and preventive and screening services, health
education, health counseling services are promoted to foster health
awareness and self-management for the beneficiary.
Following along on slide 44, the first and subsequent AWV Visits may be
billed with any medically necessary evaluation management service like
the IPPE, when billing additional E /M services, we would hope that
providers would inform the patient of cost sharing requirements for the
additional services, and append payment modifiers 25 to the claim line
submitted for payments.
Modifier 25 indicates a separately identifiable E/M service by the same
physician on the same day of the procedure or other service. Cost
sharing requirements will apply to the E /M services furnished and a
beneficiary will be responsible for any deductibles, coinsurance or
copayments that may result from the additional service.
On slide 45, the AWV does not include other preventive services that are
currently covered and paid under section 1861 of the Social Security
Act, but they may be furnished during an AWV visit when appropriate for
the individuals. On our last call, in July of 2011, several commenters
noted that some contractors were rejecting claims for preventive and
diagnostic services. One such preventive service was prostate screening
cancer, code G0102 for digital *** exam, and the diagnostic EKG
service that Tom had mentioned earlier.
Since that call, we have worked with contractors to remove any system
edits that reject these services from being furnished during an AWV
visit. If a practitioner has a rejected claim, and it has been denied
payments, they are welcome to resubmit those claims for payment at this
time.
On slide 46, from the registration page, many questions came in on
billing and Medicare non-covered preventive physical examination with an
AWV visit. Non-covered preventive services including preventive E and M
services may be billed with an AWV visit. And like the IPPE, we suggest
that the provider use an ABM to notify the patient that payments for the
additional non-covered preventive service is not covered by Medicare.
We further note that a carve-out billing is not possible with the AWV as
all of the elements must be furnished in order to bill for this service.
Non-covered E and M preventive services will have substantial overlap
with the service elements furnished in the AWV visit and practitioners
and providers are responsible for billing appropriately when providing
additional non-covered E and M preventive services.
Moving along on slide 47, the AWV has a single Medicare non-facility
payment rate under the PFS of $155.89 for the initial AWV visit and
$110.96 for subsequent visits. In our 2012 physician fee schedule final
rule, we finalized additional minutes for these services to include
inclusion of the HRA during the visit.
While we believe that the HRA is best completed prior to the AWV, we
recognize that many beneficiaries will not be able to complete the forms
without assistance from a healthcare professional, and we have allowed
for the assistance in the payment rates.
Slides 48, and 49, the remaining slides from my section furnished links
for additional preventive services, and I encourage all of our listeners
to review these materials and share them with your beneficiaries when
appropriate.
I would like to make a note of some special sites. The first slide
references the Medicare Learning Network publications where questions
regarding AWV elements can be answered. The second slide indicates the
Medicare internet manual sections while largely drafted for contractor
instructions, it does furnish important guidance on billing and payment
procedures, including the use of modifier 25.
And lastly, you can direct your patients to the general preventive
service resources and preparing them for the AWV visit and as mentioned
earlier, this is where you will find the checklist that may be helpful
in developing screening schedules for beneficiaries.
Thank you for the opportunity to present today.
On slide 50, you will find helpful websites for health professionals and
beneficiaries, and on slide 51, you will find some websites with more
information on Medicares preventive servicesm including Medicare
Learning Network resources and the CMS prevention webpage, and slide 52
provides the continuing education information that I referenced at the
start of the call.
We have now completed the presentation portion of this call, and we will
move on to the question and answer session. Before we begin, I would
like to remind everyone that this call is being recorded and
transcribed.
Before asking your question, please state your name and the name of your
organization. In an effort to get to as many of your questions as
possible, we ask that you limit your questions to just one.
All right, Holley, you may open the lines for questions. All right, to
ask a question, press star followed by the number one on your touchtone
phone. To remove yourself from the queue, please press the pound key.
Please state your name and organization prior to asking a question and
pick up your handset before asking your question to assure clarity.
Please note your line will remain open during the time you are asking
your question so anything you say or any background noise will be heard
in the conference.
Please hold while we compile the Q&A roster.
And your first question comes from the line of Stacey Josephson.
My question is regarding well-women visits; that was not a topic that
was covered today. Where can I find more information?
Can you hold on for just a moment?
Medicare does cover pap test and pelvic exams with clinical breast exam.
Additional information regarding those Medicare preventive benefits can
be found in the Your Guide to Medicare Preventive Benefits.
Unfortunately, I do not have the link with me, but if you would like to
e-mail that question, we can make sure you got the link to that.
OK. Thank you.
And the e-mail address, if you like to send that in, is on slide 53.
Thank you.
Thank you.
Your next question comes from the line of Todd Solomon.
Yes, hello. Im wondering about billing for separate E and M code
during a wellness exam for treating a chronic condition such as, maybe
uncontrolled diabetes or hypertension, where they may require a change
in medication, if that could be billed as a separate service?
Yes, they can. We do believe that it would be convenient and
appropriate to address chronic conditions during the AWV so if it is
medically necessary, you would bill the additional E and M service and
append modifier 25 to that claim line for payment.
Thank you.
Thank you.
Your next question comes from the line of Betsy Miller.
Hi, I work in an OB GYN office also and I pretty much have the question
of, I mean, can you at least say if anything has changed for the well
woman care in the GYN setting? Is it still every other year unless
youre high risk? Or, because that was the main reason I was listening
in today.
Can you hold on for one moment?
Sure. This is Jamie Hermansen again and my suggestion, again, if you are
looking for specifics regarding Medicare coverage of those types of
preventive services regarding, you know, pap tests, and pelvic exams,
and/or mammography, and related to that is to go to that publication,
The Guide to Medicares Preventive Services which is available on our
Web site. Thank you.
Thank you. Your next question comes from the line of Lynn Evans.
Hi, I have a question regarding the codes and the billing. If the IPPE
is to be billed, the G0402 codes, Im wondering, and its not a
head-to-toe physical exam, Im wondering how the V70.9 code is
appropriate?
This is Kathy Kersell, the examples in the slides of V70.0, V70.3, and
V70.9, they are basically just examples of, you know, diagnosis codes
that could be used on the claims when billing for the IPPE, and they
basically represent, just like, general or nondescript exams. Any
appropriate diagnosis code would be acceptable on the claim and they
were just basically given as examples. You do not have to use any of
those diagnosis codes when you bill for an IPPE but they were basically
just examples. We have been asked questions in the past, like, is it OK
if I use that diagnosis code? So that is why we include it as an
example.
But, isnt that incorrect billing if you bill for having done a general
physical exam but you didnt actually do one?
Well, like I said, these were just examples because any appropriate
diagnosis is acceptable, and it was my understanding that like V70.9,
I dont have the exact description in front of me at this moment
Its general physical exams.
General, and V70.0 also falls under that type of
Right V70.3 is other medical exams for admin purposes. I just Im
just not I guess its just not clear to me because they are completely
different things. If the IPPE is not essentially not hands on, its
not a head-to-toe physical and you bill for one, I think that is where
the confusion is for providers.
Well, as I said before, you do not have to use those diagnosis codes but
we have had providers just ask if they could bill those in the past and
basically since there is no diagnosis requirement other than you have to
have a valid diagnosis code on the claim, we have said if the claim
comes in with that diagnosis code for that IPPE service, you will not
have a denied claim. It will pay.
But again, that is you know, any appropriate valid diagnosis code is
acceptable. If you are not comfortable with using any of those diagnosis
codes in the examples, then you dont have to use them but you do have
to have a valid diagnosis code on the claim.
OK, thank you.
Youre welcome.
Thank you.
Your next question comes from the line of Andrea Sailas.
Hi, I just needed a more of a clarification. I just wanted to make sure
that the G0102 you stated was payable with the Annual Wellness Visit and
the IPPE. Is that correct?
Im sorry, I didnt catch the codes that you said. Was it G0102?
Yes, just prostate exam, is that payable with both of those screening
codes?
It is. It is.
OK great. Thank you very much.
Sure.
Your next question comes from the line of Sheila Hale.
And that question has been withdrawn. Your next question comes from the
line of Teri Pokorny.
Yes, I just have a question on the subsequent visits. Now they have
their annual wellness, and you use a G0438. Now, the next year, do you
use this or is this for a subsequent visit to go over everything?
This is Tom Dorsey, as a you only can use the G0438 one time, so the
next year, you would have to use a G0439.
OK. Thank you.
Thank you.
And your next question comes from the line of Suzanne Hopman.
Hi, Im sorry, I just wanted to take myself off of mute. My question is
in regard to the items that are required for the Annual Wellness Visit,
if a physician or, you know, the practice in general, the provider,
doesnt do one of the components, let us just say home safety is this
a billable service or should we be looking at using an ABN if not all
elements are there? Or do you have a guideline as to how many elements
must be there versus not be there, et cetera, et cetera?
Regarding the elements included in the Annual Wellness Visit, I would
refer you back to the slides that list the the list of that list
those specifications and if you look at I believe its slide 31 and
slide 32 of our presentation. The other thing I know that we have put
out several publications and quick reference sheet that provide
additional information about that. So those may be helpful as well.
And we can provide if you would like to e-mail your question in, we
can provide you links to those documents.
And then as well as the I can also provide you, if you would like to
go ahead and send in that question, I think we can provide you
additional feedback regarding that question.
And more information can be found on slide 48, the links to the
publications that were referenced. Thank you. OK, thank you.
Your next question comes from the line of Jessica Hemmesch.
Hello, I have a kind of a similar question having to do with the IPPE,
though. If the patient is being seen for eye care by another provider
and they may have just had their vision screened recently, then they
present for the IPPE. Is the lack of a vision screen during that IPPE a
problem or could they just say, sees their eye doctor regularly?
Would that suffice and be OK and not screen the vision at that visit?
Could you hold on for just a moment?
Im sorry, if you can go ahead and send that to the e-mail address
listed on slide 53 and you can put it to Jamie Hermansens attention
that would be great. We will get back to you on that.
OK.
Great, thank you.
Your next question comes from the line of Tori Swanson.
And that question has been withdrawn. Your next question comes from the
line of Trisha Proctor.
We are an FQ facility and we are wondering: is an IPPE and an AWV
mandatory? Because our physicians and our patients also expect the usual
comprehensive preventive visit.
And not all providers are doing the IPPE or an Annual Wellness Visit
because we dont really have all those checklists in place so we are
concerned that are we missing something that we are mandated to do in
lieu of the preventive service? Or is it OK if the provider doesnt do
an IPPE or an Annual Wellness Visit at the patient request?
Could you hold on for just a moment?
Hi, actually, we need to do a little more research on that if you could
e-mail your question to the address listed on slide 53 to Jamie
Hermansens attention and we will get back to you on that.
Thank you.
And your next question comes from the line of Arline Kirkus.
Hey, I had a question about AAAs. If a patient has risk factors and is
not eligible for an IPPE, they have already past that 12 months, can
they be referred for an AAA during their annual well?
Hi this is Kathy Kersell, and the screening AAA is only payable if done
as a referral from an IPPE for those beneficiaries that have specific
risk factors. You know, being that the Im referring to the screening
code, the G I dont have that code in front of me G0389, that code
can only be billed as a referral from an IPPE, and so
And so if they never had an IPPE, because now theyre 75 or, you know,
68 or something, we cant now refer them for that because they have
missed that opportunity?
Not for that code, that is correct.
OK, very good. Thank you.
Your next question comes from the line of Tina Pravarish.
Yes, I was just wondering for the IPPE and AWV, is it any physician
specialty can perform this, like a neurologist, gynecologist,
podiatrist?
This is Jamie. We designate in the regulations that a physician
actually can you give us just a second please?
Sure.
Hello, we are still looking into the answer, just one moment.
Thank you.
Hi, this is Jamie Hermansen and we in the regulations for health
professionals, we define a physician as, a physician who is a doctor of
medicine or osteopathy as defined in section 1861 R1 of the Act.
It could be an M.D. or D.O.
So as long as its an M.D. or D.O. they are fine, it doesnt matter what
specialty.
We dont the regulation is silent on that.
OK, thank you.
Thank you.
And your next question comes from the line of Ramona McCubbins.
Hi yes, we are a rural health clinic, and I would like to know, when
doing the IPPE, I know it covers the screening EKG and also an AAA
ultrasound. Can those two screenings be done on the same day as the
IPPE or does it have to be on a separate day?
Hi, this is Kathy Kersell. They can all be done on the same day but
keep in mind that the AAA screening does have specific coverage that has
to be met.
OK. And you also said that a screening PSA can be done during that
physical that IPPE?
Yes.
Ok. All right, and one more question, as a rural health clinic, I know
that they all roll up into a one line thing, theyre not separate.
They do not normally recognize modifiers, would I still need to use the
modifier on an E and M service along with the IPPE?
Hi, this is Bill Ruiz. Yes you have to use the 52 series modifier.
OK.
And the HCPCS code.
OK. Yes I do know that code is separate from my E and M code, theyre
the only two that do not roll up together so that it is recognized that
an IPPE was done on that day. But I just did not know whether I should
go ahead and put the 25 modifier on the office visit or not.
I believe you have to put, yes.
OK, all right. Thank you.
Youre welcome.
And your next question comes from the line of Sherry Lonewolf. Hi, this
is Sherry Lonewolf and Im calling from Cheraw Family Medicine, Im
confusing myself, if I got a new Medicare patient that is coming in and
he is getting a head-to-toe physical, do I use the G0402 or am I
supposed to use the G0402 plus the G0438?
Hi, this is Stephanie Frilling. No, Sherry, neither the G4 or the IPPE
or the AWV are a head-to-toe physical. So this would be youre
discussing three specific services: non-covered routine head-to-toe
physical examination, and then the IPPE, and then the AWV. And for the
preventive physicals, it would depend the eligibility will depend on
if the beneficiary had been enrolled in Medicare longer than twelve
months or less than twelve months.
OK, OK, thank you.
Thank you.
Your next question comes from the line of Teri Coy.
Yes, I have a question regarding the Annual Wellness Visit and the
subsequent. In the slide page 28, it talks about the annual wellness is
12 months following the IPPE but the subsequent annual is 11 months
following the initial annual so I want to clarify if those are both
correct so that the other one, it doesnt actually have to be 365 days
in between?
Hi, this is Jamie Hermansen. We would in defining that 12-month
period, we have instructed our Medicare contractors that its basically
you are counting 11 full months.
OK.
From either one of those dates.
From both of them. OK. So the 11 full months applies so they would
have lets say the 15th of the month and they come in a year later but
have it at the tenth, those three days shy is not going to make a
difference?
No, it shouldnt make a difference.
OK, that is what I want to make sure because we have been trying to do
that at this point. OK.
All right. Thank you.
Thank you.
Youre welcome.
And your next question comes from the line of Lori Jepson.
Hi, this is Lori Jepson from North Dakota. My question has to do with
the coder that asked on the head-to-toe physical, the V70.0, which
requires a physical exam. Wouldnt it be better to code either
education or medical information under a V65.49, or a treatment plan,
V65.49?
Hi, this is Kathy Kersell. Yes, you can use those diagnosis codes if
that is what you prefer. The reason we use the ones we did in the
examples, we have received questions on those diagnosis codes in the
past, and, again, any valid appropriate diagnosis code is what you
should put on the claim. You should not have any problems with the
diagnosis codes you mentioned.
OK, thank you.
Youre welcome.
Thank you.
Your next question comes from the line of Anne Herrick.
Thank you. I was wondering if there was a true 12-month separation that
would need to occur between the initial IPPE and the first annual AWV
visit?
Thanks, that is a great questionwithin our claims processing
instructions to the Medicare contractors in defining that 12-month
period, we said that the contractor needs to count 11 full months from
that date.
OK. Thank you.
Youre welcome.
Your next question comes from the line of Patina Johnson.
Hi, Im kind of confused on the EKG part. I know that you stated that if
you had any EKGs denied for diagnostics, you can re-file or appeal after
April 1. My question is does the screening EKG, what code would you use
for that if you are not using a diagnostic, would it be the V70.0? Hi,
this is Kathy Kersell. The screening EKG codes that are optional that
are done and as a referral of an IPPE, any diagnosis code would be
appropriate for them as well because they are screening diagnosis codes.
Of course, the diagnostic EKG needs a valid diagnosis but again, for the
IPPE screening EKG codes that are done as a referral from the IPPE, you
should be OK with any diagnosis code as long as its a valid code.
Are we able to do the screening EKGs through the AWV?
No, you are not.
OK.
Thank you.
Your next question comes from the line of Linda Oliver.
Thank you, Linda Oliver from Atrius Health, my question has to do with
the HRA. Is that a required component of the Annual Wellness Visit and
if so, is that incorporated or included in the coding? I believe you
said it was if the provider or the provider needs to help the
beneficiary. And the last question about the HRA, does that need to be
done annually as well?
Hi, this is Jamie again, the the statute requires that the HRA be
included and taken into account in the provision of personalized
prevention plan services, which are part of the Annual Wellness Visit.
However, and so that is the first question. Can you repeat the second
half of your question, please?
Is the HRA required each year? And then the last question is, I believe
you said that the time that the provider spends with the beneficiary if
they dont complete it is also included in the G0438 or G0439 coding.
Regarding your second question about the subsequent visits, we have
within the subsequent visits, we have it states that the HRA would
need to be updated.
Yes, this is Stephanie Frilling. And yes, during our 2012 rulemaking,
we did increase the minutes for the IPPE, the first and the subsequent
to include additional time for completing the HRA in the office during
the visit.
Thank you.
Your next question comes from the line of Carol Aiken. And that question
has been withdrawn. Your next question comes from the line of Denise
Blackiston.
Yes, hello. I would just like to confirm on page seven, who can furnish
the IPPE welcome to Medicare visit, you do have physician, you do have
your qualified non-physician practitioners, your PAs, nurse
practitioners, and CNS. Is it true that this cannot be incident to, so
the nurse practitioner saw the patient, it would not bill under the MDs
number?
Yes, that is right. For the non-physician practitioners that are
allowed to furnish the service, they would bill under their own Medicare
number.
OK, and then on page 29 to confirm who can furnish the Annual Wellness
Visit? You do have medical professionals including health educators,
registered dieticians, and so forth to other licensed practitioners or a
team of such medical professionals and its my understanding that this
would consist of the LR the licensed registered the registered
nurse, the RN.
As we discussed in the preamble during the calendar year 2011 physician
fee schedule rule, we are not assigning particular tasks or restrictions
to specific members of the team. And we believe that its better for
the supervising physician to assign specific tasks to qualified team
members as long as they are licensed in the state and working within
their states scope of practice.
This approach would give the physicians and the team the flexibility
needed to address a beneficiarys particular need on a particular day
and it also empowers the physician to determine whether a specific
medical professional would be who will be working on his or her
wellness team are needed or needed on a particular day.
And the physician would be able to determine the appropriate the
coordination of various team members during the Annual Wellness Visit.
And this would be billed, the annual wellness or the subsequent would
be billed under the physician the MD? And if it were the nurse
practitioner seeing the patient, it could still be billed I mean it
would be billed under the MDs, is what I thought you had said.
That is correct, that is right. Yes, the AWV is not sub-incident to, so
they can only be billed under the physician.
And that would be
Or they should bill itOr an MD could bill it under his/her own Medicare
number.
The direct supervision of a physician who is in the office that day
Right, and we are using the direct supervision in the office setting
which means that the physician has to be present in the office suite and
immediately available.
OK, yes, maam. Thank you so much for your time.
Sure.
Thank you.
Your next question comes from the line of Donna Morrissey. Hi, my
question is regarding the codes for the IPPE and the AWV. Are they the
same if it is a new patient or an established patient?
Hi, this is Stephanie Frilling. And yes, you would bill the same code.
OK. Thank you very much.
Thank you.
Your next question comes from the line of Dean Ruth.
Hi, this is actually (Anne Ford) and Im from North Carolina. I have a
question on the clarification for rural health clinics, if we bill for
the AWV, can we also bill for another E and M service that same day?
We are billing on a type of bill 77X.
This is Bill Ruiz and yes, you can.
And again, you report on both lines of 52 modifier
OK. I guess Im not familiar with the 52. So you put a 52 on your on
the Annual Wellness Visit and on the other E and M codes.
That is correct.
With your charges, you are still getting one flat rate for being
counted.
So there is no additional reimbursement for the
For AWV, no.
Only for IPPE because two payments, when you bill IPPE and a lot of
service on the same day. So you get two payments if you are just
splitting the allowance between the two codes?
With the IPPE?
Yes, and the E and M.
No, with the IPPE, you get two payments at the all inclusive rate, two
separate payments, that applies only to IPPE and any of the E and M or
any other service.
Not AWV, you still get one flat rate payment.
OK, I get you. OK thank you.
Your next question comes from the line of Jay Rodriguez.
And that question has been withdrawn. Your next question comes from the
line of Anita Robinson.
Hi, I wanted to know that if you have established patients already being
treated annually for preventive services, which I think you have
identified as a non-covered routine, can the IPPE be initiated by the
Medicare beneficiary?
Can you hold on for one moment?
Sure.
Hello, this is Stephanie Frilling. So are you saying an existing
patient that you furnished routine physicals for and they become
Medicare eligible? Or are you saying that a patient that you have
been furnishing non-preventive physicals for, or excuse me
preventive physicals or routine physicals and now they are requesting an
IPPE?
Yes, the latter.
The latter.
Yes.
I mean, if they are requesting that, you have not you know, if they
if you have not submitted, you know
They have to be within the first 12 months of the Part B coverage but if
they havent been furnished, an IPPE report, it wouldnt go against the
frequency edit.
Right, within the first 11 months.
And we would suggest that
11 full months.
We suggest that you take a look at the, you know, the list of elements
that are included in the IPPE as well as the Annual Wellness Visit when
you are preparing to provide those services.
OK. Thank you.
Thank you.
And your next question comes from the line of Frances Powers.
If a patient misses the IPPE, can they have an AWV, and if so, how is
this does it take much the same format, then, as the IPPE? And in
terms of the every 12 months, could it actually then be every 11 months
apparently from what you have been saying?
Hi, this is Jamie Hermansen again. A patient does not need to receive
an IPPE in order to be eligible for the Annual Wellness Visit. To be
eligible for the Annual Wellness Visit, they just need to have Medicare
Part B for longer than 12 months and then they are eligible for the
Annual Wellness Visit every 12 months.
And in defining the defining that 12-month parameter, we have
instructed our contractors to count 11 full months from either the time
that they received their IPPE if they did receive one or since their
last Annual Wellness Visit.
Thank you.
Thank you.
Your next question comes from the line of Stephen Swetech.
Come on now, ask your question.
Pick it up, pick it up, pick it up.
Hey, this is Dr. Swetech, how are you? Thanks for your venue.
I got a question, I heard that you guys had we were doing that digital
*** exam and I use a, probably, a Medicare number 0107G but I heard
you guys had given another number. The other thing is that it rejected
a bunch of those and I had trouble finding the female digital ***
code.
Do you have that?
Hold on for one moment.
Bring me the are you there?
Bring me the IQ. What was the other choice?
Hello, if you wouldnt mind, could you e-mail that question to us to the
e-mail address listed on slide 53 and we will look into it for you.
I dont have the slide 53 under me, do you have that available or
That e-mail address is prevenetionnpc@cms.
CMS dot org or what?
Its preventionNPC@cms.hhs.gov.
The other thing that I if I could if you wouldnt trouble what
happened is, now with these additional requirements on the health
referral and things, Im going to send these patients to a GI guy and
Im going to have the colonoscopy if they have any neurological
problems, I refer them out if they are depressed.
Is that good enough to write it or do we have to have a special form for
that?
Hold on for one moment.
OK, so we will look into that as well. If you could just e-mail all of
your questions to the e-mail address that we provided, and we will get
back to you as soon as possible.
That kind of throws us at a disadvantage because we are very Im a
very busy doc so when you tell us to e-mail on it, I probably I dont
know if Im going to be able to Ill try
OK.
The fact is we probably arent going to get the answers to the question.
Thank you.
Youre welcome.
Thank you. Your next question comes from the line of Barb Oliver.
When a patient is ordered an abdominal aortic aneurism screening with
the IPPE, can you go ahead and use any diagnostic code on that?
This is Kathy Kersell, the AAA screening does have specific coverage
criteria required so you would want to code the diagnosis appropriate to
that coverage criteria. If you want to have find more information
about the ultrasound screening for the abdominal aortic aneurism, the
AAA screening, you can go to the CMS Web site and look in the
internet-only manual, publication 100-4, chapter 18, section 110.
And in that section, you will find all the coverage requirements.
For the diagnostic screening codes.
This would be the ultrasound AAA screening as a referral for an IPPE.
You know, that is not the same thing as a diagnostic AAA screening code
Well, I meant that the the code that we just use a V81.2 which is a
cardiovascular screen.
So that the ultrasound can be paid for.
You are talking about a specific diagnosis code?
Correct.
Well, again, Im going to have to refer you to the coverage requirement
for the AAA screening and you would have to look at those and then
determine if that beneficiary is eligible for the AAA screening, you
would have to use a diagnosis that would fit the criteria listed in the
IOM.
So in reading that, the only requirement I have seen is that they have
to have a history of smoking.
For an AAA screening, there is more than just a history of smoking. And
you know, I mean if you want to have us respond through e-mail, we
could ask that you put your question to us and send it to the e-mail
address, but the AAA screening, again, can only be done as a referral
from an IPPE and that is G0389, and it does have limited coverage.
OK, thank you.
Thank you.
Youre next question comes from the line of John Florence.
Hey. How are you doing? Hello?
Yes, we are here.
Hey, how are you doing? I have a quick question. Is there a specific
form for the health risk assessment that I can that is accessible?
Hi, this is Jamie Hermansen. My suggestion would be to take a look at
these CDC the Centers for Disease Control framework and that
particular publication provides information about the health risks
assessment and also you may want to take a look at appendix A of that
document because it provides some examples of questions.
So that would be my suggestion. Slide 50 of your presentation slide
deck has a link to that document. OK. A second part of that question
now, also, once that once it is completed, as a physician, do you scan
that into the charts? How do we capture all of that information during
that particular visit for electronic health records purposes?
Again, my suggestion would be to go to the CDC framework document, and
it will give you some additional information about the health risks
assessment, that would be your best bet.
But as well as, if you would like to e-mail your question and we could
provide additional feedback after the call.
OK, and so pertaining to other questions, is there a particular
timeframe that I could go out and access the transcript in the other
questions that has been addressed by other peers?
Yes, we will be posting a transcript and audio file shortly, and we will
send out an announcement when it is available.
OK. Thank you very much.
Your next question comes from the line of Ashley Perry.
That question has been withdrawn. Your next question comes from the
line of Leslie Ash.
Hi, I was wondering, when we do a non-covered physical on a Medicare
patient, so that would be an E and M code, and in the same year, they go
on Medicare and we are doing this, we get an ABN or whatever, and then
they have their IPPE, the fact that we have billed out preventive care
physical will not make the IPPE deny, correct?
Yes, Im sorry, this is Stephanie Frilling from CMS. Yes, that is
correct.
OK, good.
And then also we have had several instances of our IPPEs being denied as
already having been performed because another specialist apparently has
done them. Will there be on the Medicare Web site, at some point in
time, where we can check benefits to make sure that a patient hasnt
already had that done?
Hold on for one moment.
We believe that you can always call your Medicare claims processing
contractor to check that eligibility but what we are not sure on here is
if that would go across because there are many contractors so if it
was in a different state or something like that, maybe it wouldnt show
up for you.
So if you could please e-mail it to my attention and we will get an
answer for you on that.
And I guess the other thing that we ran into here, which maybe is a
little odd. We have had a patient who was previously on Medicare, say,
ten years prior, gone off Medicare, and been reestablished with Medicare
with a new Medicare card showing an effective date, and then when we
billed an IPPE for her, it was denied because she really was not a new
Medicare patient but that was I mean we have no way of knowing that.
Again, I guess, Medicare eligibility hopefully would if you go online
with that, would be a help to us?
Thank you, its a great question. And within the regulations for the
IPPE as well as the Annual Wellness Visit, we talk about as far as the
IPPE is their first within 12 months of their first Part B enrollment
period, so
Right, which says that they can go off part B. And then they can go
back on it which on the card, it doesnt say that they were part B you
know, ten years ago so I guess for people maybe I dont know if there is
somewhere that you can make people aware of that, that that can be an
issue and we run into it. Yes, we understand and we will look into that.
OK, thank you. Thank you. Unfortunately, that is all the time we have
for questions. If we did not get to your question today, you can e-mail
it to us at PreventionNPC@cms.hhs.gov.
That e-mail address is also listed on slide 53. If you have a question
for a particular speaker, please reference their name in the subject
line. We will also be researching all questions and we will post
responses as appropriate to the CMS website and an announcement will go
out when these are posted.
Before we end the call, for the benefit of those who may joined the call
late, please note that Continuing Education credits may be awarded by
the American Academy of Professional Coders, the American Health
Information Management Association, or the American Medical Billing
Association for participation in CMS National Provider Calls.
Please see slide 52 of the presentation for more detail.
On slide 54, you will find information and a URL to evaluate your
experience with todays National Provider Call. Evaluations are
anonymous and strictly confidential. All registrants of todays call
will also receive an e-mail from the CMS National Provider Call resource
box within two business days regarding the opportunity to evaluate this
call.
You may disregard this e-mail if you have already completed the
evaluation.
We appreciate your feedback.
I would like to thank everyone for participating in todays call. An
audio recording and a written transcript will be posted soon to the
National Provider Calls and Events section of the Fee-For-Service
National Provider Calls webpage at www.cms.gov/npc.
Again, my name is Leah Nguyen and it has been a pleasure serving as your
moderator today. I would like to thank our presenters, Jamie Hermansen,
Kathleen Kersell, Stephanie Frilling, Thomas Dorsey, and Bill Ruiz for
their participation.
Have a great day, everyone.
Thank you for viewing this Medicare Preventive Services video slideshow
presentation. The information presented in this presentation was correct
as of the date it was recorded. This presentation is not a legal
document. Official Medicare program legal guidance is contained in the
relevant statutes, regulations and rulings.