Welcome to Medicare Physical

sstone

Contributor
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Can someone tell me how a "Welcome to Medicare Physical" should be billed? The codes the provider used are 99397, G0344, G0366 and 81003. It looks like it's being rejected saying it's a routine physical. I'm not sure what to correct to get it paid. Any suggestions are appreciated.

Thank you,
Sharon
 

rthames052006

True Blue
Local Chapter Officer
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1,905
Location
York, Pa
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Can someone tell me how a "Welcome to Medicare Physical" should be billed? The codes the provider used are 99397, G0344, G0366 and 81003. It looks like it's being rejected saying it's a routine physical. I'm not sure what to correct to get it paid. Any suggestions are appreciated.

Thank you,
Sharon
Don't bill the 99397 that is a "routine cpt e/m code" just use the

G0344 for the IPPE
g0366 for the ekg

The 81003 is not part of the welcome to medicare.

Have a good day,
 

desiree384

Contributor
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I also suggest requesting free educational material from the cms.gov website such as "The ABCs of Providing the Initial Preventive Physical Examination Quick Reference Chart." It is listed under the medicare learning network.
 

daniel

True Blue
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Just a heads up, this is only billable in the first 6 months of the patient receiveing medicare.

Daniel
CPC
 
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