Staying Independent...Together

Print Message

   RE: Medicare coding
 From: Kathy Saradarian
 To: Member Forum
 Posted: 01-23-2017 14:14
 Message: G0101 is the code for breast/pelvic exam
Q0091 is for the collection of the PAP
-33 is for any prevention service.

G0009 - is the code for pneumonia vaccine administration.  

Kathy Saradarian
Original Message:
Sent: 01-23-2017 01:35
From: Melissa Weakland
Subject: Medicare coding

You can use and should be reimbursed for -13 assuming you have ICD-10 to connect to it- i.e. whatever problem you discussed ( atrophic vaginitis or HTN or whatever). Then place -25 modifier on your -13 and use the G code for whatever part of prevention exam you did.

did you do this and not get paid? 

You can also do a Medicare wellness with its g code and then use another appropriate G code for the prevention exam portion.  I found out the hard way no -25 modifier here. If you place it you just won't get paid for that line.

Come to the March call, 1st Wednesday in March- what's that code?   You can ask all these questions or any other code questions and hear what others though the years have figured out.

i think Medicare and procedure coding hugely helpful to share tips. I just learned about proper vaccine coding and now get more than a hundred more dollars a visit because of it. So I'll be on the call. I always glean something most helpful. 

Melissa Weakland MD
Ballard Neighborhood Doctors
Seattle WA
IMP since 2007
Original Message:
Sent: 01-16-2017 09:30
From: Tracy Baum
Subject: Medicare coding

I have a fairly large Medicare population and am having issues with coding a 'well woman' exam. Since Medicare does not have preventative codes for this. Some references say us an E/M plus the G codes for pelvic/ CBE, and collection I'd Pap specimen. But when I tried this, the claim was sent back (by Athena - which we are in the process of dumping) saying the 99213 was not allowed. Ugh. What's the best way to get reimbursed for these visits?

I do promote the Medicare Annual Wellness Visits for my patients. Do you combine this with a physical?


Tracy Baum
Mountain Sage Family Clinic
Dubois, WY

Copyright 2016 Ideal Medical Practices. All rights reserved.