Annual Visits

Can someone please help me. i have been billing Procedure code 99214 with a G0446 or aq G0447. the ovvice visit is being paid put the go446 or g0447 is not getting paid denial reason is: it is included in the in the office visit. can someone please tell me if there is a modifier that needs to be used. I have been using modifier 33. Is this correct. HELP!!!!!!!!!!!!!!!!!!!

re: Annual Visits

Look into 59 or 25 also look at GQ or GT. Of course the mod must be appropriate for the encounter. Mod33 is not needed on codes that are considered actual preventive codes. Also, you stated it denied inclusive, which is not the same thing as rejection caused by modifier misuse.

re: Annual Visits

the G code gets the modifier 33 correct

re: Annual Visits

Do not append modifier 33 for Medicare or Medicaid claims. Claims submitted to Medicare with modifier 33 will be returned with Medicare Outpatient Adjudication (MOA) code MA130, which indicates that the claim contains incomplete and/or invalid information and is therefore “unprocessable.” As such, you should only append modifier 33 for non-Medicare payers, as per AMA instructions.

re: Annual Visits

Thanks For Your Help

re: Annual Visits

i have billed G0446 with modifier 33 and united helathcare advantage plan has denied it as inclusive to another procedure. that was the first denial they gave me so i billed it out with the modifier 33 and it is still being denied what am i doing wrong please help me. So frustrated :(

re: Annual Visits

Probably the payers own policy to deny inclusive. Some payers dislike G codes. Research it on their website or call the payer and ask them. Might have to delve into a CPT® book for the answer.

re: Annual Visits

Hi:

I am a medical student looking for primary care practitioners conducting Intensive Behavioral Therapy (IBT) for Obesity as reimbursed by Medicare (G0447). My goal is to learn how different PCPs are conducting weight loss counseling. If you would be able to discuss this with me, please email me at Araba_Amonu@brown.edu. Thank you.