G0444

[Kerri]

So we started billing for G0444. Priority Health Medicare is denying for bundling.  I tried first without a Mod 25, and then WITH a Mod 25. both were denied. I have looked and looked online but there isn't any concrete information.  A few posts suggested billing with Mod 59? 

Is anyone billing for this and getting paid?

[Michele]

What codes are you billing with it?  Are the other codes being paid?  Is this code being denied or bundled?

Sorry, need more information.

[Kerri]

Billed to Priority Health Medicare with 99397. The physical gets paid, the G0444 gets denied for unbundled. I have tried the 99397 with and without mod 25

[Michele]

Medicare only allows one G0444 in a 12 month period.  Is it possible that the patient had one in the past 12 months.