Editing Update for Annual Wellness Visit (AWV)
Currently, for claims with dates of service on and after January 1, 2011, processed on and after April 4, 2011, the business requirements in CR 7079 allowed for an AWV visit (HCPCS G0438 or G0439) on an institutional claim and a professional claim for the same patient on the same day. In some cases this has resulted in overpayments. This CR provides instructions for edits to be modified to only allow payment for either the practitioner or the facility for furnishing the AWV.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 26, 2012
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