E/M Weekly Tip: Initial Preventative Physical Examination (IPPE) and Annual Wellness Visit (AWV)

When the physician or qualified non-physician practitioner (NPP), provides a significant, separately identifiable medically necessary E/M service in addition to the Initial Preventative Physical Examination (IPPE) or an Annual Wellness Visit (AWV), CPT codes 99201 through 99215 may be reported depending on the clinical appropriateness of the circumstances.

Note: Some of the components of a medically necessary E/M service (e.g., a portion of history or physical exam portion) may have been part of the IPPE or AWV and should not be included when determining the most appropriate level of E/M service to be submitted for the medically necessary, separately identifiable, E/M service.

For more information, please visit the Medicare Claims Processing Manual, 100-04, chapter 12, Section 30.6.1.1 H at CMS website (PDF, 1.12 MB).