DTAYLOR1076
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Hello our physician at our practice used an E/M code of 99397 for a Dx code Z89010, this is a Medicare patient is this coding correct? Will Medicare pay?
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Wiki History of Colonic Polyps and E/M Codes
I don't work the back end of things (I have a slave that handles all that thankfully. 
) , but from what I understand Medicare won't pay 99397, or any physicals (for example if you have someone under 65 on Medicare).
Our docs usually bill an E/M (99202-99215 with a modifier 25) with a wellness visit (G0402, G0438, or G0439 depending on their Medicare start dates). For example:
99212 - 25 - I10
G0439 - Z00.00
Not saying this is how your doc's should be doing it. As always it depends on what was done that day and documentation.
Here's some info on the wellness visits
http://www.wpsmedicare.com/j8macpartb/resources/provider_types/awv-faq.shtml
This really explains a lot when it comes to Medicare and physicals and the wellness visits.
http://www.capturebilling.com/am-i-just-dealing-with-coding-department-that-is-ignorant/
Hope this helps!
) , but from what I understand Medicare won't pay 99397, or any physicals (for example if you have someone under 65 on Medicare). Our docs usually bill an E/M (99202-99215 with a modifier 25) with a wellness visit (G0402, G0438, or G0439 depending on their Medicare start dates). For example:
99212 - 25 - I10
G0439 - Z00.00
Not saying this is how your doc's should be doing it. As always it depends on what was done that day and documentation.
Here's some info on the wellness visits
http://www.wpsmedicare.com/j8macpartb/resources/provider_types/awv-faq.shtml
This really explains a lot when it comes to Medicare and physicals and the wellness visits.
http://www.capturebilling.com/am-i-just-dealing-with-coding-department-that-is-ignorant/
Hope this helps!