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Terry Posted Tue 19th of May, 2020 13:54:40 PM
When coding a GI claim , say for example EGD or Colonoscopy; Does a modifier need to be used for G0500, and does anything need to be entered in box 19 or any times units in 24G. Or can the code itself G0500 simply be added.
SuperCoder Answered Wed 20th of May, 2020 15:37:24 PM

Hi Terry,

Thank you for your question.

There is no modifier required to bill for G0500 (Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)  as it is only payable for GI procedures.

Also, we can use +99153 for additional minutes.

If you are a non-physician practitioner and do not have a medical license number, please use your social security number in box 19.

For 24G: Days or Units - Enter the number of medical visits or procedures, units of anesthesia time, oxygen volume, items or units of service, etc. Do not enter a decimal point or leading zeroes. Do not leave blank as units should be at least 1.

Kindly see the below link for further instructions.

Terry Posted Wed 20th of May, 2020 20:12:47 PM
Thank you very much! I appreciate it!
SuperCoder Answered Thu 21st of May, 2020 02:00:18 AM

Thank you, happy to help.

Terry Posted Thu 21st of May, 2020 12:11:22 PM
Do you if most commercial insurers are recognizing the G0500 code or is it pretty much just Medicare? Terry
SuperCoder Answered Fri 22nd of May, 2020 09:13:09 AM

Yes, Code G0500 is recognised by all commercial payers, however it is only payable for GI procedures. Thank you.




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