1. marilyn
   Member
   Posted 1 year ago #
   

   Effective July 1, 2010, what is the allowed units to bill Medicare for code 'G0431'? I heard it's 4. Does anyone know?

2. Anonymous
   
   Posted 1 year ago #
   

   Present CMS has assigned no frequency limits for G0430 and G0431. Since these are new codes, they have not yet been assigned Correct Coding Initiative frequency limits (MUEs). It is expected that, in the near future, G0430 will be assigned an MUE value of 1 since CMS would not expect the code to be reported more than one time for each date of service. G0431 will probably be assigned a higher, but unpublished, frequency limit. It is CMS policy to keep frequency limits they believe may be abused confidential. 80101 had MUE of 16 so it can be expected that the same would apply to its replacement code.]

3. Rose Laurenxo
   Member
   Posted 1 year ago #
   

   Yes It is 4 unit cause I this time I am getting denials from medicare for more than four units. I would like to know if anyone knows to to bill more unit correctly with a modifer

4. Alicia Morris
   Member
   Posted 1 year ago #
   

   I BILL GO431 QW WITH 5 UNITS, KEY IT BY LINE- EXAMPLE GO431 QW 1
   G0431 QW 1
   G0431 QW 1
   G0431 QW 1
   G0431 QW 1
   Medicare MLN states G0431 QW will be paid the same as 80101 QW- Have no ideal why it needs to be by line to pay.

5. marilyn
   Member
   Posted 1 year ago #
   

   I have billed AR Medicare G0431QW 1 X 4 LINES AND GOT PAID FOR MAYBE 3 CLAIMS, THEN, GETTING DENIALS AGAIN. EXACTLY, DOES ANYONE KNOW THE EXACT BILLING FORMAT FOR AR MCR?

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