Forum - Questions & Answers

Jan 16th, 2012 - loreebar 2 

Behavioral counseling code for obesity screening for Medicare

Can we charge both the G0447 and office visit together with modifier when seeing patient with Medicare? Also does anyone know if other insurances are paying for this service or not?

Jan 16th, 2012 - Codapedia Editor 1,399 

re: Behavioral counseling code for obesity screening for Medicare

When I check the NCCI edits, my editor doesn't find data for G0447. I don't think they will be bundled by Medicare. G0447 is for counseling, not screening. I still don't find a transmittal or MLN matters article, but the NCD coverage is described here:

http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?&NcaName=Intensive%20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&NCAId=253&

There are transmittals and article about screening for depression, screening for alcohol use and alcohol counseling.

https://www.cms.gov/Transmittals/2011Trans/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=2&sortOrder=descending&itemID=CMS1254345&intNumPerPage=10
CMS Transmittal and MLN Matters for depression screening:
http://www.cms.gov/transmittals/2011trans/itemdetail.asp?itemid=CMS1254352


The RVUs for these services are very low. All are time based (15 minutes). If done on the same day as an office visit, that would require 15 additional minutes documented.

I expect private payers will pay for them because they have an A or B rating from the USPTF and so group insurers will add them to their benefits. My opinion--we'll see.



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