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Thread: G0438 and G0439

  1. #1

    Question G0438 and G0439

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    I have received a question from one of our physicians in regards to these new codes for 2011. The question that I have been asked is:
    "If a patient is scheduled for a routine physical (G0438 with dx V70.0) and in the course of that appointment the patient and physician discuss at length problems (ex hypertension, sore throat, etc). Would it be acceptable to bill a rtn visit code (99212-99215) in addtion to the G0438 with a modifier?" If so what kind of documentation would support this- would he need two seperate notes or could he note this also in his physical note? Anyone know the answer or have any suggestions?

    Thanks,

    Molly

  2. #2
    Join Date
    Apr 2007
    Location
    Macomb
    Posts
    9

    Default

    Hi Molly,

    I asked a similar question on the Medicare regulations forum yesterday, and someone did post a very helpful reply with a link on CMS.
    K. Patrician, CPC

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