Wiki Billing tips for G0447

[jlm1117]

I am doing billing for a Nephrologist who does thourough weight loss counseling for obese patients with ckd. We started billing for G0447 in addition to the e/m code and have not been getting paid for it. Anyone have any suggestions?
Thank you

 

[TThivierge]

Hi jlm
Well are using the G0447 for Medicare patients but as first dx you should use E66 or E63 or certain related R dx codes along with proper documentation. Also the commercial carrier CPT runs from CPT 99401 to 99409 per amount of minutes . The provider must list amount of minute on med documentation for the day for diet and smoking counseling discussion. Along with notions on diet or smoking behavior. Provider might say discussed 15 minutes with pt on diet plop on CPT 99401 on the claim. Also cannot do CPT 96157 health behavior codes same day as these CPT 99401-99409. However if patient has chronic problem est pt visit such as 99213 for Dementia or Migraines or CHKD put the stage down , you can add the diet behave health CPT code 99401 with modifier 25 since differ problem during same visit. Also if pt overweigh or obese add the Z68 matching the BMI % in the record. Ensure dx Z codes are at the end of the claim , Z71.3, Z68 and Z71.2 exercise counseling if given.
I hope this data has helped you.
Lady T