Medicare Annual Wellness Exam - Virginia Society of Medical
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Transcript Medicare Annual Wellness Exam - Virginia Society of Medical
Medicare Annual Wellness
Exam
Presented by:
Susan Duden, CPC.
March 24, 2012
Medicare Preventative Services
Welcome to Medicare exam and physical
Vaccines
Various Screening procedures
Annual Wellness exam
Welcome to Medicare physical
Must be performed within 12 months of the
patient’s effective date of Medicare part B
Once in a lifetime procedure
Screening EKG is only allowed if referral
from the IPPE appointment
G0402
Vaccines
Flu Vaccine, one per flu season
Pneumococcal, 1 per lifetime, unless at risk
patient
HBV, limited to high risk patients
Various screening Procedures
Prostate blood screening, 1 per year
Mammography, 1 per year
GYN, every 24 months unless at high risk
Colonoscopy, 1 per ten years
Bone Mass Measurements, 1 per 24 months
Etc.
Annual Wellness Exam
Allowed 1 per year
Cannot be done within a year of the Welcome
to Medicare Physical
12 months apart
G0438, first visit for wellness exam
G0439, subsequent visits, every 12 months
Who can perform this exam?
Doctor of Medicine or Doctor of Osteopathy
Nurse practitioner
Physician Assistant
Clinical Nurse Specialist
Health Professional
Health educator, registered dietitian, nutrition
professional or a team of medical professionals
working under the direct supervision of a
Physician
What is included in the Annual
Wellness Exam?
This is not a hands on physical!
Patient History
Benign examination
Counseling
Establishing the Medical/Family
History
Collect and document the following:
Past medical and surgical history
Allergies
Use or exposure to medications and supplements
Family history for disease or illness that may be
hereditary or place beneficiary at increased risk.
A list of providers and suppliers the patient is
currently using
Review of patient’s Risk Factors
Screening for depression
Screen for risk of falls
Questions on home safety
Questions on hearing impairments
Cognitive abilities
The abilities to perform activities for daily
living
Benign Examination
Height
Weight
Body Mass Index (BMI)
Blood pressure
Establishing a Written Screening
Schedule
Make a check list for the next ten years
Based on the patient health status and history
Include age appropriate preventative services
Up to and including bone mass measurements,
prostate cancer screening, colonoscopy,
mammography, seasonal flu vaccine and
pneumococcal vaccine, and, if the patient meets
the Medicare guidelines, a hepatitis B vaccine.
Establish a List of Risk Factors
Risk factors or conditions where intervention
might be necessary
A list of treatment options and their
associated risks and benefits
Furnishing advise to patient on
preventative counseling
Personalized health advice with referrals as
appropriate
Including weight loss, physical activity, smoking
cessation, fall prevention nutrition and alcohol
abuse
Subsequent Annual Wellness Exams
Frequency is 1 per year
Updating any of the provider or supplier
information, family history, etc
Assessing cognitive impairment
Weight, BMI, Blood pressure
Continued Counseling
Update the written screening schedule
developed at the initial wellness exam
Update any risk factors that may have been
identified
Personalized referrals as appropriate.
Including lifestyle interventions, weight loss,
physical activity, smoking or alcohol cessation,
fall prevention and nutrition.
Frequently asked questions
Is the AWV the same as a yearly physical?
Are clinical laboratory tests part of the AWE?
Is there a deductible or coinsurance due for
the AWE?
Can a separate E&M be done on the same
day?
What the Patient should bring to the
Annual Wellness Exam
A full list of current providers and suppliers
involved in providing care
Family Health history with as much detail as
possible
Medical records, including immunization records
A full list of medications
Including supplements such as calcium and vitamins
How often and how much are they taking
Questions?
CMS links for Preventative
Information
http://www.cms.gov/PrevntionGenInfo/
https://www.cms.gov/MLNProducts/downloa
ds/MPS_QRI_IPPE001a.pdf
https://www.cms.gov/MLNProducts/35_Preve
ntiveServices.asp
https://www.cms.gov/MLNProducts/downloa
ds/AWV_Chart_ICN905706.pdf