mrf4d
New
Hi, I have a provider who is seeing patients strictly for obesity, that is the only condition covered during the visit. For example, patient presented to discuss being prescribed a GLP-1 like Zepbound. For Medicare patients, the provider is billing for an E/M visit, usually CPT 99213 and G0447. The criteria is met for G0447, as far as time and 5 A's documented, but I don't think it's appropriate to bill both an E/M and G0447 for the same condition. It feels like double dipping. There's guidance in CPT and Codify that state CPT 99401/99402 are separate procedures that shouldn't be billed with an office visit, but I can't find any guidelines from Medicare addressing this. I have checked MLN matters, NCD, everywhere I know. Can someone please help?