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What is included in a Physical (Not MCR )

  1. #1
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default What is included in a Physical (Not MCR )
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    We are having a discussion re what are the requirements for 9939_-9938_. Doc's want to charge G0102 for a BX pt, prostate screening. Our Docs get pd by RVU's. I believe that this code is specific to Medicare. I was wondering if anyone else charges for this? Thanks for your help in advance.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I don't think I would code separately for G0102 for two reasons:
    1 - preventive codes are age and gender specific, so the prostate exam would be part of the MALE preventive exam.
    2 - most carriers that I am aware of do not recognize G codes.

    Also, since we would not usually report G0101 separately for a non-Medicare female patient, why would we report G0102 separately for a non-Medicare male patient?

    Just my opinion...

  3. #3
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Thumbs up Physicals
    Thank you for your opinion. We are a Critical Care Facility and our providers are using RVU's. They get paid this way.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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