Results 1 to 4 of 4

Help for billing code 99375 medicare

  1. Default Help for billing code 99375 medicare
    Exam Training Packages
    I am getting denials from medicare for codes 99374-99375, stating that I am using the incorrect modifier...I have been using Modifier "GV"...Medicare denies this for inconsistency...any suggestions as to what modifer will get my claims paid? Any help appreciated...

  2. #2
    Hartford, CT
    There ar different codes depending on the patient's setting, 99374-75 are for patients under the care of a home health agency, 99377-78 are for hospice patients and 99379-80 are for nursing home patients. Modifier GV states "Attending physician not employed or paid under arrangement by the patient's hospice provider". If the patient is enrolled in a hospice, then the correct code would be 99377 or 99378 rather than 99374-99375. If the patient is not enrolled in a hospice then you do not need the GV modifier.

  3. #3
    Default Care Plan Oversite
    For Medicare patients in an assissed living facility use G0182, Medicare will not pay for care plan oversites for nursing facilites any longer.

  4. Default 99374/75
    My clearing house is denying these codes, and they are not included on the Medicare Fee Schedule. Patient is not hospice

Similar Threads

  1. Help! Billing Medicare HCPCS Code P9603
    By eventidesky in forum Pathology & Clinical Laboratory
    Replies: 3
    Last Post: 11-12-2014, 01:14 PM
  2. Avonex billing code/Medicare reimbursment
    By brwilliams45 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 01-31-2014, 11:06 AM
  3. 99374/99375
    By HBULLOCK in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-16-2010, 08:42 AM
  4. Billing a catheter code 51702 to Medicare
    By bedington in forum Billing/Reimbursement
    Replies: 0
    Last Post: 05-13-2010, 03:25 PM
  5. 99374-99375 for Peds
    By Angela Schwarzkopf in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 10-28-2009, 10:55 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.