Forum - Questions & Answers

May 28th, 2012 - sreshta 45 

New reimbursable G codes for medicare

Hi everyone

I billed the new G codes "G0444,G0442,G0445,G0446,G0447 for medicare, got paid for G0444 and denial for the rest of the codes as CO-185 (The rendering provider is not eligible to perform the service billed, M27 N95(This provider type\provider speciality may not bill this service. My provider specialities are "internal medicine and cardiology", i went through some cross referrences and found that the following provider speciality types may submit these G codes
01-GENERAL PRACTICE
08-FAMILY PRACTICE
11-INTERNAL MEDICINE
16-OSTETRICS/GYNECOLOGY---------
etc
my provider speciality is internal medicine and cardiology so he should get paid for these codes then why is medicare denying for payment.
AM i missing something, please explain me where i am going wrong

May 29th, 2012 - Codapedia Editor 1,399 

re: New reimbursable G codes for medicare

Medicare processes claims based on only one specialty code. You determine that when you enroll the physician in Medicare. Which is listed first? Cardiology or IM?

May 31st, 2012 - sreshta 45 

re: New reimbursable G codes for medicare

Cardiology is listed first and IM second

May 31st, 2012 - Codapedia Editor 1,399 

re: New reimbursable G codes for medicare

So, that's the reason it's not paid. CMS only uses the first physician specialty code to process claims, not the second.

Jun 1st, 2012 - sreshta 45 

re: New reimbursable G codes for medicare

Yah
Got it
Thanks



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