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g0452 code

SuperCoder Posted Wed 15th of October, 2014 10:37:56 AM

How do you specifically bill G0452 code in Florida and what are the requirements, such as any specific diagnosis, etc. Multiple interpretations billed should be billed as G0452-26 with subsequent codes listed with the -59 or -91 modifiers? Is this code being paid by the Florida medicare contractor?

SuperCoder Answered Thu 16th of October, 2014 07:09:52 AM

Thank you for your question.

For Florida (except Fort Lauderdale and Miami) payment information is as below:

G0452- 26 shows a Facility/Non Facility Price of $19.63 and Limiting charge of $21.45 according to the Medicare Fee Schedule

http://www.cms.gov/apps/physician-fee-schedule/search/search-results.aspx?Y=0&T=0&HT=0&CT=2&H1=G0452&C=58&M=5

Modifiers 59 and 91 would not be appropriate to bill with G0452.

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