Medical Billing Forum

Coding => Coding => Topic started by: Brenda09 on June 27, 2011, 07:27:28 AM

Title: G0246
Post by: Brenda09 on June 27, 2011, 07:27:28 AM
Hello,

Is there a CPT code equivalent to G0246 for payers other than medicare?

Thanks,
Brenda
Title: Re: G0246
Post by: Michele on June 28, 2011, 10:28:52 AM
Wouldn't it just be the regular E&M codes?  99211-99215?
Title: Re: G0246
Post by: Brenda09 on June 28, 2011, 04:39:15 PM
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
Title: Re: G0246
Post by: Michele on June 29, 2011, 10:37:31 AM
You mean the G code billed with another code and the G code is being denied?
Title: Re: G0246
Post by: Brenda09 on June 29, 2011, 09:15:04 PM
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.
Title: Re: G0246
Post by: Michele on June 30, 2011, 01:06:32 PM
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).
Title: Re: G0246
Post by: Brenda09 on June 30, 2011, 09:21:51 PM
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
Title: Re: G0246
Post by: Michele on July 02, 2011, 08:25:42 PM
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.