Medical Billing Forum
Coding => Coding => : Brenda09 June 27, 2011, 10:27:28 AM
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Hello,
Is there a CPT code equivalent to G0246 for payers other than medicare?
Thanks,
Brenda
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Wouldn't it just be the regular E&M codes? 99211-99215?
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Hi Michele,
The physician thought there might be a comperable code to Medicare G code. The denials say procedure not payable seperately, but she wanted me to research it and see if there was another code before doing a write-off.
Thanks,
Brenda
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You mean the G code billed with another code and the G code is being denied?
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Yes, it is denied by medicare with a primary code & 25 modifier. The physician feels this should be a service paid seperately by other payers as well as medicare. Because the G code is only for medicare, she feels there should be another code for this service with other payers in addition to the primary code.
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Was the 25 modifier on the G code or on the E&M code?
I'm actually a little confused after I went back and reviewed the original post. Your initial question was for a cpt equivalent to the G code but it appears you are trying to deal with a denial not replace the code. I thought you were looking for a code to use in billing other insurances (other than Medicare).
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Sorry about the confusion. The 25 modifier is on the E/M code. But you are correct, what I was looking for was a code in additon to the E/M that included foot check for diabetics for payers other than medicare. I am not sure one exists, but the physician wanted me to research it.
Why there was confusion, the physician used the G code to bill other payers. I just started billling for this physician and found this while doing A/R.
Thanks for hanging in there with me.
Brenda
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Oh, that makes more sense. I'm not aware of any code other than the Medicare G code. Sometimes the commercial payors follow Medicare's lead and begin using the G code or else the AMA introduces a CPT code.