Wiki G0447 POS

[vnorman]

Hello!

I just took over the billing from an outsourced billing company and have discovered several claims that were denied (Medicare) for G0447 and the place of service. The service was rendered to patients in an assisted living facility and some in their private homes. I have not seen this issue in the past, and can not locate restrictions of POS for this code. Can anyone help me?

Thank you in advance!

Valarie

 

[bridget936]

I would like to know this info as well. My providers are wanting to know if they can bill the G0447 for pt's in the nursing home or skilled nursing facility.

 

[CBLENNIE]

Have you reviewed the Medicare NCD 210.12 Intensive Behavioral Therapy for Obesity which references that these services are to be performed by a qualified primary care physician or other primary care practitioner and in a primary care setting? They do not consider a SNF and most likely a nursing facility as a primary care setting per the NCD. I don't know if the patient's residence or an assisted living facility would be considered a primary care setting, you might need to contact your MAC for information regarding whether these POS are considered a primary care setting.