Part B Insider (Multispecialty) Coding Alert

Published on Fri Jan 07, 2011 PDF

No need to resubmit claims, the MAC says.

Last week, we gave you the breakdown of how various MACs were dealing with the new annual wellness visit (AWV) codes G0438-G0439. This week, another carrier made an announcement about its stance on the codes, and unfortunately, it involves inappropriate denials.

Cahaba GBA, a Part B MAC for four states, said on Jan. 28, "Cabaha GBA was one of the contractors that auto-denied claims with G0438-G0439 when billed with a routine service diagnosis code. Mass adjustments will be initiated on January 31, 2011. No provider action is required."

Bottom line: Keep an eye on all AWV claims that you may have submitted to Cahaba in January, and if an adjustment doesn't come through, contact the MAC directly using your provider relations contact information.