# Medicare changing codes!



## Lisa Bledsoe (Oct 23, 2008)

Here's a new one - We submitted 99397 to Medicare in order to get the denial for the supplement.  They *CHANGED* our code to to the IPPE code G0344!!  No EKG was performed AND the patient was past his 6 month window.  The carrier is TrailBlazers.  They told our rep the EKG was not required and that they have _*"they right to make that change"*_!  For one, there are specific guidelines and documentation that must be met for G0344 and the Medicare manual specifically states that by *STATUTE* the EKG (G0366) MUST be performed!  I am so frustrated with TrailBlazers.  They make more mistakes than I have ever encountered in my 10+ years of coding and dealing with Medicare!  

Sorry - had to vent.


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## Teresa Collins (Oct 23, 2008)

We have submitted a 99397 with a GA modifier (the patient had signed a waiver) to Medicare and have not had any problem with Trailblazer.  I wonder if the modifier would have made a difference in this case.  

Just a thought.....

Teresa Collins, CPC


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## Lisa Bledsoe (Oct 23, 2008)

That's a good point, but I would use GY (you don't need an ABN for 99397).  However, they should not be changing our codes...that's my frustration.


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