Coding and Documentation for Preventive Services

Unlock the full potential of preventive care services in this comprehensive webinar designed for providers, coders, and billing professionals. Preventive Power: Coding Essentials for Medicare Wellness and Preventive Visits delivers a practical, real-world approach to navigating the complexities of Medicare preventive services.

Participants will gain a clear understanding of the documentation and eligibility requirements for the “Welcome to Medicare” visit, also known as the Initial Preventive Physical Examination (IPPE), including timing, required elements, and common pitfalls. The session will also break down the components of both Initial and Subsequent Medicare Annual Wellness Visits (AWVs).

Participants will learn the key elements of a comprehensive preventive evaluation—typically associated with commercial payers—and how these differ from Medicare benefits, which do not cover routine comprehensive preventive exams.

The session will also provide guidance on documentation and billing requirements specific to Medicare-covered breast, pap, and pelvic exams.

Attendees will also learn how to appropriately report additional medically necessary services performed on the same date as a wellness or preventive visit, including proper use of modifiers and supporting documentation requirements.

Through interactive discussion and real-world scenarios, participants will have the opportunity to test their knowledge, ask questions, and clarify gray areas. The session will conclude with actionable strategies for improving workflow and streamlining processes to support efficient delivery and billing of preventive services.

Whether you're new to Medicare preventive services or looking to refine your current processes, this webinar will equip you with the tools and confidence to succeed.

• Identify the documentation and eligibility requirements for the "Welcome to Medicare" (Initial Preventive Physical Examination - IPPE).
• Explain the components of the Initial and Subsequent Medicare Annual Wellness Visits (AWV).
• Describe the elements of a Comprehensive Preventive Evaluation.
• Outline the documentation and billing guidelines for Breast, Pap, and Pelvic exams.
• Engage in an open discussion to analyze real-world scenarios and clarify participant questions.
• Evaluate the rules of providing additional services on the same date as a wellness or preventive visit.
• Discuss workflow/process for conducting and billing these preventive services.
• Identify common pitfalls and challenges in Medicare preventive service coding and billing to ensure compliance.
• Differentiate between Medicare preventive benefits and comprehensive preventive evaluations typically covered by commercial payers.
• Apply appropriate modifiers and supporting documentation requirements for billing additional medically necessary services on the same date as a wellness or preventive visit.
• Develop actionable strategies for optimizing workflow and streamlining processes for efficient preventive service delivery and billing.
• Understand the timing requirements for the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visits (AWVs).
• Recognize the financial implications of accurate coding for Medicare preventive services.

• Understanding the "Welcome to Medicare" Visit (IPPE)
• Medicare Annual Wellness Visits (AWVs)
• Live Q&A Session
• Distinguishing Comprehensive Preventive Evaluations
• Coding and Billing for Specific Preventive Exams
• Reporting Additional Medically Necessary Services
• Common Pitfalls and Compliance
• Workflow Optimization
• Real-World Scenarios
• Advance Care Planning (ACP)
• Health Risk Assessments (HRA)
• Personalized Prevention Plan Services (PPPS)
• Cognitive Impairment Assessment
• Telehealth and Preventive Services
• Commercial vs. Medicare Rules
• Audit Triggers
• Live Q&A Session

• Provider
• Clinician
• Coder/Biller
• Compliance Officer or Administrator
• Practice Manager
• Medical Assistant
• Nurse Practitioner
• Physician Assistant
• Revenue Cycle Specialist
• Healthcare Consultant
• Office Staff involved in patient intake and scheduling
• Patient Educator
• Front Desk Staff
• Medical Director
• Quality Improvement Coordinator
• Health Information Manager

Shellie Sulzberger, LPN, CPC, ICDCT-CM, is a Licensed Practical Nurse and a Certified Professional Coder. She received her Bachelor of Science degree in Business Administration from Mid America Nazarene University. Ms. Sulzberger received her nursing license in 1994 and was a practicing clinician at Saint Luke’s Health System for several years before transferring to the internal compliance/audit area. She became credentialed as a Certified Professional Coder in 1996 and assisted Saint Luke’s Health System with performing medical record chart audits to verify the accuracy of the internal coding and claims processing.

Ms. Sulzberger spent approximately six years as a coding/billing consultant with national accounting and consulting firms (BKD, Grant Thornton) before becoming the President of Coding & Compliance Initiatives, Inc. (CCI) in April 2003. Ms. Sulzberger assists her clients with improving their operational performance in a variety of critical outcome areas, including coding/billing, corporate compliance, charge capture processes, etc. Ms. Sulzberger works with a variety of health care providers including hospitals, physician practices, and rural health clinics in their daily compliance and operational activities.

A substantial amount of Shellie’s time is spent providing education with the physicians and internal coding staff regarding opportunities for the clinic to improve its current documentation and coding practices, which impact both the revenue and compliance risk of the facility.

Shellie works extensively with federally qualified health centers across the country (along with physician practices, rural health clinics, and hospitals), serving as an independent auditor and compliance resource to improve documentation quality, coding accuracy, workflow, and revenue cycle performance. She works collaboratively with the National Association of Community Health Centers (NACHC) and State Primary Care Associations (PCA), including speaking at Revenue Cycle 360 and several Primary Care Associations’ annual conferences and other educational conferences.

She assists legal counsel with research, investigation, and her expert opinion. She also provides clinical education in the areas of patient management and medical record documentation. She attends many physician and other staff meetings to offer updates and to act as a liaison for the health care provider.

Ms. Sulzberger presents locally and nationally on coding topics, as well as developing specialized training programs to meet the needs of her clients. Shellie works with the front office and back office revenue cycle team members, focusing on education regarding E/M and ICD-10 coding and billing guidelines and coding/billing-related processes that improve compliance and cash flow.

She emphasizes communication between the billing team and the providers and clinicians about the “downstream” impacts of incorrect coding.

Shellie personally works with 10+ health centers annually regarding documentation, coding, and billing processes and serves as an education resource for several State PCAs each year.

Shellie is credentialed through the American Institute of Healthcare Compliance as a Certified ICD-10 Trainer.