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Medicare Wellness

Rhonda Posted Fri 20th of May, 2016 12:42:53 PM
When billing Medicare advantage (private insurance), we are told we can bill a 99397 along with a G0402, or G0438, or G0439. Do we need a modifier 25 to attached to one or both lines when billing. Also when billing a G0402, or G0438 or G0439 along with a screening code such as G0444 do we need a modifier 25 on the wellness?
Rhonda Posted Fri 20th of May, 2016 15:07:21 PM
When billing Medicare advantage (private insurance), we are told we can bill a 99397 along with a G0402, or G0438, or G0439. Do we need a modifier 25 to attached to one or both lines when billing. Also when billing a G0402, or G0438 or G0439 along with a screening code such as G0444 do we need a modifier 25 on the wellness? - See more at: https://www.supercoder.com/my-ask-an-expert/topic/medicare-wellnessA#post-45016
SuperCoder Answered Mon 23rd of May, 2016 02:04:48 AM
Hi, You can only bill one or the other (medicare annual wellness or a preventative examination). However if documentation supports it you can split bill the visit with a 99212 or 99213 with a modifier 25 attached. Also, as per CCI edit G0444 is bundled into G0402, or G0438 or G0439. These codes cannot be billed together in any circumstances. Thanks

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