Wiki Medicare G0402 and EKG

[mgarcia400]

For a Welcome to Medicare visit G0402, I know and EKG 93000 is allowed. I'm having trouble getting the 93000 paid as Medicare states it's unbundled. Am I coding this incorrectly? Should I be coding G0403 for EKG with G0402 and not 93000? Any insight is appreciated!

 

[sls314]

For a Welcome to Medicare visit G0402, I know and EKG 93000 is allowed. I'm having trouble getting the 93000 paid as Medicare states it's unbundled. Am I coding this incorrectly? Should I be coding G0403 for EKG with G0402 and not 93000? Any insight is appreciated!

This is not my area of expertise, but everything I can find says that you should use G0403.

I looked up the CCI conflicts. There is a CCI conflict between G0402 and 93000. There is not a CCI conflict between G0402 and G0403.

Additionally, I've pasted some info below from the AAFP website:

https://www.aafp.org/family-physici...d/coding/preventive-physical-examination.html

IPPE Coding​

The four HCPCS codes used to report IPPE services and ECG screenings are:

• G0402 – IPPE is a face to face visit. Service is limited to a new beneficiary during the first 12 months of Medicare enrollment.
• G0403 – Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report)
• G0404 – ECG performed as a screening for the IPPE (tracing only without interpretation and report)
• G0405 – ECG performed as a screening for the IPPE (interpretation and report only)

 

[mgarcia400]

This is not my area of expertise, but everything I can find says that you should use G0403.

I looked up the CCI conflicts. There is a CCI conflict between G0402 and 93000. There is not a CCI conflict between G0402 and G0403.

Additionally, I've pasted some info below from the AAFP website:

https://www.aafp.org/family-physici...d/coding/preventive-physical-examination.html

IPPE Coding​

The four HCPCS codes used to report IPPE services and ECG screenings are:

• G0402 – IPPE is a face to face visit. Service is limited to a new beneficiary during the first 12 months of Medicare enrollment.
• G0403 – Electrocardiogram (ECG) performed as a screening for the IPPE (with interpretation and report)
• G0404 – ECG performed as a screening for the IPPE (tracing only without interpretation and report)
• G0405 – ECG performed as a screening for the IPPE (interpretation and report only)

Thank you for the response and information!