Author Topic: G0246  (Read 2901 times)

Brenda09

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G0246
« on: June 27, 2011, 07:27:28 AM »
Hello,

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

Thanks,
Brenda

Michele

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Re: G0246
« Reply #1 on: June 28, 2011, 10:28:52 AM »
Wouldn't it just be the regular E&M codes?  99211-99215?
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Brenda09

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Re: G0246
« Reply #2 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

Michele

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Re: G0246
« Reply #3 on: June 29, 2011, 10:37:31 AM »
You mean the G code billed with another code and the G code is being denied?
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Brenda09

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Re: G0246
« Reply #4 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.

Michele

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Re: G0246
« Reply #5 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).
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Brenda09

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Re: G0246
« Reply #6 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

Michele

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Re: G0246
« Reply #7 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. 
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