Wiki depression screening G0444 modifier

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abranch13

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We have been filing the G0444 depression screening to Medicare along with an E/M for their visit, these had been processing and paying with no problem.....we just started getting denials on the G0444 for modifier, thinking they are wanting a 25 on the E/M, has anyone else ran across this??

Thanks
 
CO4-The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The G0444 and E/M both were filed with no modifiers
 
abranch13 said:
CO4-The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

The G0444 and E/M both were filed with no modifiers
Click to expand...
Our editing software indicates we should use a -59 modifier. We've filed claim but have had a response yet. Which is a good indication that it may not deny!
 
I'm receiving the same denial as you are (CO-45 - Inconsistent modifier). The OV has a 25 modifier on it as well. When I look up to see what modifiers are billable in the AAPC Coder - It only gives 80, 81 & 82, which are surgery modifiers. So I'm not sure what the deal is.

Is ANYONE getting paid for this service??:confused:
 
We are getting the same response. Is anyone getting paid for this? Also we have many assisted living patients and we do these at the facility. Medicare is saying not payable at this type of facility. Why would I have to bring these patients to the office to do the service? Would like some help !
 
After I mentioned my previous comment, AAPC Coder has recently changed the approved modifiers for 99420 - 25 is now approved. That's what I've been using if/when on the same day as a bundled service, such as a flu admin (90471). Hope that'll work.
 
We have been filing our G0444's with a 25 on the E/M to Medicare are receive payment without any issue. However, we do have an issue with most of the Medicare Advantage plans, most are denied the first time we file and have to be appealed and some are requiring records be sent.
 
We are also wondering if this will be covered, when we billed, it was with the following codes:
G0438
99213-25
81002
93000
G0444

The G0444 is being denied, but looking at the CMS website, I think it should be covered. We are being told we should bill with the GZ modifier, does this sound correct?
 
I realize this is an old post, but is it possible they are looking for mod-33?

From CPT Assistant:

Modifier 33, Preventive Service: When the primary purpose of the service is the delivery of an evidence-based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by appending modifier 33, Preventive Service, to the service. For separately reported services specifically identified as preventive, the modifier should not be used.
 
E/m with go444

Colliemom said:
We are also wondering if this will be covered, when we billed, it was with the following codes:
G0438
99213-25
81002
93000
G0444

The G0444 is being denied, but looking at the CMS website, I think it should be covered. We are being told we should bill with the GZ modifier, does this sound correct?
Click to expand...


HI ALL!,

I put the 25 modifier on the level & for G0444 i put XU modifier. Both went through. :)


Jennifer Collins CPC
 
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