Wiki G0439 vs G0101

Create Wiki
B

Babsss

Networker
Local Chapter Officer
Messages
78
Location
Anniston, AL
Best answers
0
I really need some clarification on these codes. When to use one over the other. Our billing manager wants to use the G0439 on all once a year medicare patients. I disagree. If they have a PCP, wouldn't they use that code. We get alot of rejections and I do not like passing this on to the patient. Can someone please help me on this. :confused
 
What is done during your provider's visit? If they are touching the patient and doing a physicial, G0101.

G0439 is NOT a physical exam. It's consulting on end of life planning, eye exam, hearing exam, etc. Pt is never touched.

CMS has several resources on their website that will clarify this for you.
 
Thank you. My boss just doesn't understand. She is not a coder. Could you give me an area in cms that will help state my case.
 
go on CMS for AWV. there is a tool that you can use. Provider needs to touch all components in order to bill G0439 EXCEPT Pschy.
 
New Patient w/MCR

My question is what if patient is a new patient referral and he performs annual wellness exam? Am I still using the G and Q codes?
 
Last edited:
You must log in or register to reply here.
Top