Category Archives for Medicare Billing Tips

Medicare Billing for a Well Woman – G0101, Q0091, G0438, G0439, 99387 & 99397

Medicare Billing for Well Woman Exam Using Codes G0101 and Q0091 and Annual Wellness Visits AWV G0438 and G0439 As we are all aware, Medicare now allows for the Annual Wellness Visit (AWV) G0438 or subsequent AWV G0439, but how does this relate to an annual Well Woman Exam?  IT DOESN’T. An annual Well Woman Exam is a completely separate evaluation and management service from an AWV, and unless the provider specifically evaluates a patient for both the AWV and Continue Reading

Filed Under: Annual Wellness Visit Tips, Billing & Coding Tips, Featured Blog Posts, Medical Billing and Coding Topics, Medicare Billing Tips

“Welcome to Medicare Visit” aka IPPE aka G0402

Initial Preventative Physical Exam (IPPE) G0402 is Known as the “Welcome to Medicare Visit” to Most Medical Billers What is a Welcome to Medicare visit, and how do you bill for it?  Let’s see if I can help to explain and to point you in the right direction for information. A patient who has just qualified for Medicare Part B is allowed this once-in-a-lifetime benefit within the first 12 months of Medicare eligibility. Medicare calls this exam the Initial Continue Reading

Filed Under: Featured Blog Posts, Medical Billing and Coding Topics, Medicare Billing Tips

Medicare G0438 – G0439: Two Annual Wellness Visit Codes

Medicare provides coverage for Annual Wellness Visits. This benefit was included in the Affordable Care Act of 2010. Medicare has come up with two HCPCS codes for these well visits for medical billing purposes. The codes are G0438 and G0439.

Filed Under: Annual Wellness Visit Tips, Featured Blog Posts, Featured Doctor Media, Featured Manager Media, Featured Medical Billing Articles, How to Bill Medicare, Medical Billing and Coding Topics, Medicare Billing Tips

Medicare Codes for Flu Shots: Q2034, Q2035, Q2036, Q2037, Q2038

Medicare Influenza Vaccine Q Codes The Centers for Medicare & Medicaid Services (CMS) no longer recognizes and does not reimburse CPT Code 90658 Influenza Virus Vaccine, Split Virus for flu shots. CMS has established six separate influenza vaccine HCPCS codes to distinguish between the brand-names of influenza vaccines for governmental tracking purposes. Make sure to use these new codes in your medical billing. Although the new Medicare codes distinguish between vaccine brands for Medicare, the HCPCS code G0008 Administration of Influenza Virus Vaccine Continue Reading

Filed Under: Billing & Coding Tips, Medical Billing and Coding Topics, Medicare Billing Tips

Medicare Hospice Modifier GV and GW

Medicare: How to use Modifier GV and Modifier GW We do medical billing for physician offices that do Care Plan Oversight (CPO) for Hospice Patients.  When billing for those services, G0182, we use the following Medicare modifiers: GV Modifier The GV modifier is used when a physician is providing a service that is related to the diagnosis for which a patient has been enrolled into hospice. This physician is not associated with the hospice and is providing services as the attending physician. GW Modifier Continue Reading

Filed Under: Medical Billing and Coding Topics, Medicare Billing Tips

Medicare Advance Beneficiary Notice (ABN): A Quick How-To

Does Your Medicare Patient Need To Sign An Advance Beneficiary Notice (ABN) CMS-R-131? Yes!  When applicable, your Medicare patients should always sign an Advance Beneficiary Notice (form CMS-R-131). An ABN is not used for commercial insurance companies. What Is An ABN? An ABN is a Medicare waiver of liability that providers are required to give a Medicare patient for services provided that may not be covered or considered medically necessary. An ABN is used when service(s) provided may not be reimbursed Continue Reading

Filed Under: Medical Billing and Coding Topics, Medicare Billing Tips

Commonly Used Medicare Modifiers – GA, GX, GY, GZ

Medicare ABN Specific Modifiers – GA, GX, GY, GZ We get a lot of questions at our medical billing company about which modifiers to use when submitting charges to Medicare. Specifically, we are often asked how to indicate whether or not an ABN (Advanced Beneficiary Notice) was given to the patient.  These are the top 4 Medicare modifiers we use. GA Modifier: Waiver of Liability Statement Issued as Required by Payer Policy. This modifier indicates that an ABN is on file and Continue Reading

Filed Under: Featured Blog Posts, Medical Billing and Coding Topics, Medicare Billing Tips

Medicare Changes GA and Adds GX Modifier for Advanced Beneficiary Notices

Medicare GA and GX Modifiers Changed As of April 1, 2010, Medicare has changed the way you need to report that a Medicare patient signed an Advanced Beneficiary Notice (ABN).  Medicare has revised the GA modifier and added a new GX modifier you must consider when doing medical billing. Medicare GA Modifier Prior to April 1st, the GA modifier read “waiver of liability on file.”  The new revised description is “waiver of liability statement issued, as required by payer policy.” Use this Continue Reading

Filed Under: Billing & Coding Tips, Medical Billing and Coding Topics, Medicare Billing Tips