From the Research
The recommended ICD-10 code for an annual wellness visit under Medicare is Z00.00 (Encounter for general adult medical examination without abnormal findings). To use this code:
- Document the visit as an Annual Wellness Visit (AWV)
- Ensure the visit meets Medicare's AWV requirements
- Use Z00.00 as the primary diagnosis code on the claim Additional information:
- If abnormal findings are discovered during the visit, use Z00.01 instead
- For an initial AWV, use G0438
- For subsequent AWVs, use G0439
- These codes are specific to Medicare and help ensure proper reimbursement This code is appropriate because it accurately describes a routine health examination for adults without any specific complaints or abnormal findings, which aligns with the purpose of an annual wellness visit under Medicare guidelines, as supported by recent studies such as 1.
The use of ICD-10 codes for annual wellness visits is crucial for proper reimbursement and documentation, and studies have shown that AWVs can lead to improved preventive care for the elderly, as seen in 2. Furthermore, the implementation of RN-led models of care for AWVs can increase completion rates and alleviate primary care provider burden, as described in 1 and 3. However, the specific ICD-10 code for AWVs remains the most critical factor for accurate billing and reimbursement.
In terms of morbidity, mortality, and quality of life, the use of Z00.00 for AWVs can contribute to better health outcomes by ensuring that patients receive necessary preventive services, as highlighted in 2. By prioritizing the use of this code, healthcare providers can help improve the overall health and well-being of their patients, while also reducing the risk of errors or delays in reimbursement.
Overall, the recommended ICD-10 code for an annual wellness visit under Medicare is Z00.00, and its use should be prioritized to ensure accurate documentation, reimbursement, and improved health outcomes, as supported by the most recent and highest-quality studies, including 1.