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Coding G0463 with 97802/97803

  1. Default Coding G0463 with 97802/97803
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    We have been billing the MNT codes 97802 or 97803 with an "A" code for Medicare. Have been trying to bill the "B" services with G0463, but was denied. From going through the NCCI Edit Tool, the two can be billed together, but require a modifier. Cannot imagine what the modifier for such a combination might be. Anybody have experience with such a billing?

    Thanks in advance for any knowledge you may be able to provide!
    Last edited by bbl4ck; 10-08-2018 at 05:21 PM. Reason: Wrong code in title

  2. #2
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    Are you billing for professional (CMS-1500) and Facility (UB-04)? The G code is for UB-04 services for OPPS/APC payment purposes.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  3. Default
    Yes, doing billing for both...

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