tci Part B Insider - 2011 Issue 42

Reader Question: Patient Wants Physical But Refuses AWV? Document Everything

Question: Several of our patients have presented to our office for a complete preventive physical. They tell us they've heard that the annual wellness visit (AWV) is not comprehensive and therefore they don't want it, so we document this fact and charge an established patient preventive medicine exam (such as 99397). Then when the patients get the denials from Medicare, they call the MAC to complain and the MAC tells them "your doctor didn't code it correctly to get it paid." The patients then call us and complain that we miscoded their claims. What is the solution to...

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