Annual Wellness Visit Tips

The Annual Wellness Visit (AWV) is exactly what it says it is... a Wellness Visit. It is a wellness visit during which the beneficiary's medical history, risk factors, functional ability and routine measurements are all captured in order to provide a Personalized Prevention Plan which the beneficiary may choose to follow to maintain good health. The AWV is NOT the same as a yearly (annual) physical exam.

Both the first AWV and subsequent AWVs have a checklist of elements which must be provided, or provided and referred, before submitting a claim for the AWV. These checklists can be found for your use on a quick reference factsheet at the following link: www.cms.gov/MLNProducts/downloads/AWV_Chart_ICN905706.pdf

A Medicare beneficiary who is no longer within 12 months after the effective date of his/her first Medicare Part B coverage and who has not received either an Initial Preventive Physical Examination (IPPE) or an AWV within the last 12 months is eligible for an AWV. Medicare Part B will pay for one initial AWV and a subsequent AWV yearly thereafter. There is no coinsurance or copayment on the part of the beneficiary for the AWV.

An AWV can be performed by the following health professionals:

·         physician (doctor of medicine or osteopathy)

·         qualified non-physician practitioner such as a physician assistant, nurse practitioner, or clinical nurse specialist

·         health educator

·         registered Dietitian

·         nutrition professional

·         other licensed practitioner

·         team of such medical professionals working under the direct supervision of a physician

 You can help your patients prepare for the AWV by advising them that this is NOT a physical exam or "check-up", and encouraging them to come prepared with the following:

Medical records, including immunization records

Family health history

A full list of current medications and supplements

A full list of current providers and suppliers involved in their care

The following resources are helpful in understanding the AWV in greater detail:

 The Guide to Medicare Preventive Services - www.cms.gov/MLNProducts/downloads/mps_guide_web-061305.pdf

 Medicare Benefit Policy Manual - www.cms.gov/manuals/downloads/bp102c15.pdf

 Change Request 7079 - Annual Wellness Visit - www.cms.gov/transmittals/downloads/R2159CP.pdf

 Medicare Learning Network Preventive Services Educational Products Website - www.cms.gov/MLNProducts/35_PreventiveServices.asp

Prepare for ICD-10 Implementation!  The time to learn about the transition from ICD-9 to ICD-10 is here. Practice administrators have multiple changes looming, including upgrades to 5010 transactions, Meaningful Use, and new relationships with hospital systems as accountable care organizations emerge.

Read the "Code of Conduct" article published in the July 2011 MGMA Connextion Magazine (page 13) to learn more about ICD-10 and what you can do to prepare, train, and succeed.