Wiki G0446 & G0442 modifiers

[krubino21]

When billing CPTs 99214 & G0446 & G0442. Would you apply the -59 modifier to the G codes or the -25? I've received conflicting information from various payers. Medicare does pay with the -59 however, Connecticare medicare, Aetna, Medicare and BCBS Medicare request the -25. The G codes are more of an E&M code, I tend to think the -25 is most appropriate. Please advise.

 

[BenCrocker]

Do what the individual carriers require unless it goes counter to the guidelines.

 

[krubino21]

Thank you

Thank you.
But for correct coding purposes, which modifier should be applied.
I don't want to code based on reimbursement.

 

[BenCrocker]

Clearly Medicare wants 59, And the other Medicare Advantage plans wants something different, it's entirely up to the carrier.