Wiki MODIFER FOR G0444

[mesafam6]

Can anyone tell me which modifier is correct to use for the G0444?IS IT THE XU OR 33? WE started getting denials from optum stating per ncci edit rules , modifier needed. we bill :
G0439
99397-25
99214-25
G0444- XU? 33?
G0442
PLUS ALL OTHER REPORTING CODES.
THANK YOU.

 

[swetap]

Sometimes Optum are asking for modifier and we use modifier 59 with G0444. Sometimes they are paying sometimes not. Maybe you can try with 59 modifier. Thank you.

 

[mesafam6]

Thank you for your response, when you are billing for the AWE G0439/G0438 are you using Z00.00? I have providers who bill for an AWE and 99397 and 99213 ( MA PLANS), they have multiples codes to bill (E11.9,I10,E78.5,E03.9, F33.41 ETC..) I'M NOT SURE IF I'm suppose to be billing these codes with the AWE OR THE 99397 Per Medicare, it says no specific diagnosis is required, but, UHC is saying we can't use z00.00 with the AWE. Please advise. thank you.

 

[swetap]

No, you can't use all the diagnoses with AWE/99397. You only need to bill Z00.00 with AWE/99397 and rest of the diagnoses with E/M codes if any. We are doing the same and even UHC is paying for AWE/99397. Thank you.