Virginia Medicaid

[stellerdobes]

I am trying to bill Virginia Premier (which is a part of medicaid) for a wellness visit.  I am using code 99397 est patient well exam and its telling me its the not the right code.  I have looked every where does anyone know what the code is

[kristin]

Is that code on their fee schedule? If not, you will have to find another code. If it is on the fee schedule, does the patient meet the parameters? 99397 is for patients 65 years or older. Is the patient that old? Is this a situation where the patient also has Medicare (maybe as primary) and a G code should have been billed instead? Need more information from you to answer correctly.

[medwave]

Agreed with Kristin. Medicaid is for younger individuals; Medicare for the elderly.

Medicare G0438 – G0439: Two Annual Wellness Visit Codes
https://capturebilling.com/medicare-g0438-g0439-two-new-annual-wellness-visit-codes/

[stellerdobes]

we are in va and some adults that meet the thresh hold have medicaid also.  We also have Va Premier plans that act as dual coverage for medicare and medicaid

[stellerdobes]

No this patient does not have medicare.  She has Va Premier Medicaid only.  She is not old enough for Medicare but has no job and meets the threshold for Medicaid

[Michele]

Is that code on the Medicaid fee schedule?  They may have a different code like Medicare does.