A full physical exam, 99397, is different than an Annual Wellness Visit, G0438/G0439, or “Welcome to Medicare Exam”, G0402.
A full physical 99397 or 99387 is NOT covered by Medicare and patients are responsible for the cost and can be billed. There is no fraud or ignorance here but there was a failure in communication from the doctor’s office.
Lastly, we come to the Comprehensive Preventative Medicine Exam. Patients and medical providers refer to this exam by such names as a routine physical, annual physical, annual exam, well exam, routine exam, full physical, annual routine physical, etc.
Regardless of what the exam is called, the CPT codes 99397 (established patient) and 99387 (new patient), which represent the preventive care examination, have very specific parameters and are never reimbursed by Medicare.
Additionally, billing the 99397 (not covered by Medicare) and billing the AWV at the same time is not fraudulent and can be billed if that is exactly what happened and the physician has the proper documentation.
Full Article:
https://capturebilling.com/am-i-just-dealing-with-coding-department-that-is-ignorant/