Wiki Screening codes

[alysenb]

Can someone help clarify something? Is a depression screening (G0444) and cardiovascular risk screening (G0446) included in AEV (G0439)? I am pretty sure the depression screening is but wanted confirmation.

 

[lgardner]

G0444 is included in both the IPPE (G0402) and the initial AWV (G0438).

it can be billed with the subsequent AWV (G0439)

per WPS:

Bundling​

In some cases, Medicare bundles depression screening into other services.

Depression screening can occur in the same visit as an evaluation and management (E/M) service. The depression screening service typically bundles into the E/M service. The E/M service requires Medicare to assign patient liability. Patients often do not understand why they receive a bill for the E/M service.

Medicare uses the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits to determine bundling.

Follow these steps to determine if a code pays separately:

• Use documentation to determine which procedure codes to bill
• Go to the CMS NCCI PTP Coding Edits web page
• Choose PTP Coding Edits from left side menu
• In the Related Links section, select the link based on the:
  • Provider type
  • Date of service
  • Procedure code performed along with depression screening
• Verify if HCPCS code G0444 is in column B with the other procedure code in column A
• Use indicator in column F to verify if Medicare allows use of a modifier
  • To report a modifier, documentation must support a separately identifiable service

Common services performed with G0444 and bundling status:

• Initial Preventive Physical Exam (IPPE) G0402
  • G0444 bundles as a component of G0402
  • No modifier overrides this edit
• Annual Wellness Visit (AWV), initial G0438
  • G0444 bundles as a component of G0438
  • No modifier overrides this edit
• Annual Wellness Visit, subsequent G0439
  • G0444 is separately billable from G0439
  • No edit is active, no required modifier
• Evaluation and Management (E/M) Services
  • G0444 bundles as a component of the E/M
  • Use column F to verify Medicare allows use of modifier to indicate Medicare considers the services separately
  • When documentation supports it, use a modifier to show a separately billable service

 

[AngMar]

G0444 is included in both the IPPE (G0402) and the initial AWV (G0438).

it can be billed with the subsequent AWV (G0439)

per WPS:

Bundling​

In some cases, Medicare bundles depression screening into other services.

Depression screening can occur in the same visit as an evaluation and management (E/M) service. The depression screening service typically bundles into the E/M service. The E/M service requires Medicare to assign patient liability. Patients often do not understand why they receive a bill for the E/M service.

Medicare uses the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits to determine bundling.

Follow these steps to determine if a code pays separately:

• Use documentation to determine which procedure codes to bill
• Go to the CMS NCCI PTP Coding Edits web page
• Choose PTP Coding Edits from left side menu
• In the Related Links section, select the link based on the:
  • Provider type
  • Date of service
  • Procedure code performed along with depression screening
• Verify if HCPCS code G0444 is in column B with the other procedure code in column A
• Use indicator in column F to verify if Medicare allows use of a modifier
  • To report a modifier, documentation must support a separately identifiable service

Common services performed with G0444 and bundling status:

• Initial Preventive Physical Exam (IPPE) G0402
  • G0444 bundles as a component of G0402
  • No modifier overrides this edit
• Annual Wellness Visit (AWV), initial G0438
  • G0444 bundles as a component of G0438
  • No modifier overrides this edit
• Annual Wellness Visit, subsequent G0439
  • G0444 is separately billable from G0439
  • No edit is active, no required modifier
• Evaluation and Management (E/M) Services
  • G0444 bundles as a component of the E/M
  • Use column F to verify Medicare allows use of modifier to indicate Medicare considers the services separately
  • When documentation supports it, use a modifier to show a separately billable service

Thank you so much for providing this very useful information with instructions as well.