G0438 question

If a doctor uses G0438 for their AHA exam, and a removal eg:17000 can you use the modified 25 on the G0438 or would you use a 51 on the 17000, Thanks

Apr 2nd, 2012 - rphelps 615 1

re: G0438 question

You would not use a 51 because it is a multiple procedure modifier. I would think you could use a 25 on G0438 and get paid for 17000.

Apr 4th, 2012 - Codapedia Editor 1,399

re: G0438 question

I agree. Modifier 25 on the G0348 since it is a type of E/M service. I'd watch carefully and make sure it was paid, and if your MAC isn't allowing them you know you either a) are doing the procedure for free or b) need to ask the patient to return to the visit at a later date. But, don't tell your doctor it was me who suggested b. :)