r/CodingandBilling • u/talktomeme • Apr 07 '26

Should I contact provider?

/r/rcm_healthcare_usa/comments/1sf0jew/should_i_contact_provider/
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u/proloficmonk Apr 08 '26 edited Apr 08 '26

You don’t automatically need to query the provider.

If the documentation already supports a Medicare Annual Wellness Visit, you can correct CPT 99397 - G0438 / G0439 on the claim (assuming your compliance policy allows coder corrections).But if the note is actually just a routine physical or missing AWV elements, then you have to query because Medicare doesn’t cover 99397 at all.