Need help with G codes and code 96160

Messages
3
Location
Middletown, DE
Best answers
0
We sent a claim to medicare with the following codes and paid on a few but G0444, 96160 and G0008, I called Medicare as was told to add a Modifier on all three. Can someone help me on what I need to do. Also with code 96160, can this code be billed with other codes or strictly by itself? Can 96160 and a G code be billed together? New at billing G codes, Appreciate any help, thanks,
G0439 pd
99214 Mod 25 pd
G0444
96160
90662 pd
G0008
90471 pd
 
Messages
143
Best answers
0
We sent a claim to medicare with the following codes and paid on a few but G0444, 96160 and G0008, I called Medicare as was told to add a Modifier on all three. Can someone help me on what I need to do. Also with code 96160, can this code be billed with other codes or strictly by itself? Can 96160 and a G code be billed together? New at billing G codes, Appreciate any help, thanks,
G0439 pd
99214 Mod 25 pd
G0444
96160
90662 pd
G0008
90471 pd
For Medicare patient's you should only bill G0444 for a depression screen. You cant bill both G0444 & 96160. I am surprised that 90471 was paid because G0008 is the correct administration code that should be billed with a flu vaccine. If we bill 90471 with a flu vaccine instead of G0008 it gets denied. The way we would bill this to Medicare is as follows:
G0439
99214 25
G0444 XU
90662
G0008
 
Messages
3
Location
Middletown, DE
Best answers
0
Thank you rthomas for the above. This really helps. Can you help me understand code 96160. I have a claim with 96127 & 96160, 96127 paid and not 96160, why? I know 96160 can not be billed by itself it has to have an E/M code attached to it, right? what are the other ways a 96160 can be billed. Appreciate your help.
 
Messages
143
Best answers
0
Thank you rthomas for the above. This really helps. Can you help me understand code 96160. I have a claim with 96127 & 96160, 96127 paid and not 96160, why? I know 96160 can not be billed by itself it has to have an E/M code attached to it, right? what are the other ways a 96160 can be billed. Appreciate your help.
I am not sure what type of practice you are in but I am in an Internal Medicine and Pediatric practice. In my experience many payers consider 96127 & 96160 to both be depression screenings. The way we utilize these codes are as follows:
96160 we use for depression (PHQ-9) screening during wellness exams with dx Z13.31
96127 we use for ADD/ADHD (Vanderbilt) assessment/follow up with dx F90.0 - F90.2
 
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