Wiki Coding for Depression Screening

[numberslil@aol.com]

When coding for "depression screening" during a preventive visit the docs are coding the Z00.00, G0444 "Annual Depression Screen" along with Z13.89 -- denial states charge is inclusive. Question: should we be adding a modifier 59? 33?

 

[twcfpc]

For Medicare patients? If yes, then no you should not have to add any modifier in my experience. But the G0444 is inclusive to the IPPE (G0402) and 1st AWV (G0438). So it is only payable during the Sub SWVs (G0439). Hope that helps.

 

[jess50906]

From all that I have read, if you are trying to do a depression screening on a date that you are seeing the patient for a preventive visit, then the depression screening is bundled with the preventive visit.

However, if you are not seeing the patient for a preventive visit and are seeing them instead for an E&M visit, then you can bill for both the E&M and G0444 with modifier 25 appended to E&M.

 

[sheenamb]

I'm afraid I disagree wholeheartedly with the last comment. Depression screening(in the form of a PHQ-9 in our case) is always covered as a separate service when done with a preventive visit, whether the policy is Med B, Medicare Advantage, commercial or Medicaid. The worst case scenario is that, in some BCBS and ConnectiCare commercial policies, they may pass the approx. $8.68 on to the patient as a coinsurance, but they still consider it a covered service. Do not miss out on a very easy way to be reimbursed for work done.
Also, as an aside, I have found that very few payers pay for depression screening and smoking cessation on the same DOS.

 

[jhendrix08]

In the case that a patient is seen for the subsequent Medicare Wellness (G0439) and we bill for the Advance care planning (99497) and vaccines (pneumonia, for example), would we need a modifier for the depression screen? If so, what would you use? Have you had trouble getting this paid when multiple things like this are done in the same visit??

I've been wondering about billing for the PHQ-9 but have never found a solid answer; a lot of yes you can and no you can't.

I really appreciate your help!!