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what is the difference between annual, routine physical and well women

Lillian Posted Mon 10th of October, 2016 16:04:53 PM
what is the difference between annual, routine physical and well women for billing.
SuperCoder Answered Wed 12th of October, 2016 05:11:05 AM

Yearly/annual wellness visit (Initial, G0438 & subsequent, G0439) is a preventive physical exam that includes a review of the patient’s medical and family history, maintaining a list of current providers and prescriptions, patient’s details such as height, weight, blood pressure, and other routine measurements, any cognitive impairment, risk factors and treatment options, screening/preventive services. This is covered once every 12 months which means that 11 full months must have passed since the last visit.

Annual Routine Physicals/Preventive Medicine Services (99381-99397) is the face- to-face comprehensive, multi-system examination based on the patient’s age, gender, and identified risk factors. The comprehensive history obtained as part of the preventive medicine E/M service is not problem-oriented and does not involve a chief complaint or present illness. It includes a comprehensive system review and comprehensive or interval past, family, and social history as well as a comprehensive assessment/history of pertinent risk factors. Includes clinical laboratory tests. This is an annual benefit.

A well woman exam is basically an annual screening of a woman’s reproductive health which includes the examination of breast, pelvic, PAP smear, etc. It can be performed by a PCP, NPP, or an OB/GYN and is less extensive than a comprehensive medical examination.

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