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G0431 & g0434

  1. #1
    Location
    Delaware, OH
    Posts
    46
    Default G0431 & g0434
    Medical Coding Books
    Hello -

    I need some help from all you laboratory experts. We have a pain mgmt. provider who says they can bill G0431 AND G0434 together on the same day during the same patient encounter. Can they do that? I can't find anything that says you can or you can't.

    Not sure what Medicare says on this.
    If anyone has advice or a link that would be great.

    Thank you!!!

  2. #2
    Location
    Denver Colorado
    Posts
    287
    Default
    G0434 is bundled by NCCI edits into the G0431 code and you cannot use a modifier to bypass this bundling edit.

  3. #3
    Default
    Shelley

    Just so I understand clearly your providers are performing a moderate and a high complexity screening on the same date of service for that one specimen?

  4. #4
    Location
    Nashville
    Posts
    20
    Default
    They cannot do that. That's a good way to get a sure fire AUDIT!!

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