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G0250 - aloowable dx codes

  1. #1
    Bentonville, Arkansas
    Default G0250 - aloowable dx codes
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    Can anyone help me with billing G0250? I can find the aloowable dx codes, and everyone I ask says they never get paid, but I cannot find any guidance on exactly how it should be billed. I know the tests have to be done one week apart and you can only bill every 29 days, but how do you indicate the days the tests were done on? Has anyone had any success with billing this code to Medicare?

  2. #2
    UT Dallas, TX Chapter
    Default G0250
    AAPC addresses this code in one of their past news feeds. Here is the link.

  3. #3
    Default Answer?
    that link still does not address the questions asked and i am interested as well in the answers. 4 units, not more than testing once per week- but do we bill g0250 with 4 units once a month or g0250 one unit on each day a test was reported to us?

    Quote Originally Posted by airart View Post
    AAPC addresses this code in one of their past news feeds. Here is the link.

  4. #4
    What POS is everyone using???

    We've billed a 12 and was denied and we've billed an 11 and still denied?

    Does anyone have any suggestions?

    thank you!

  5. #5
    We've been somewhat succesful billing the G0250 to Medicare. We bill with an office POS (11) we put the testing dates in block 19 to show the 4 tests we're billing and that they're not more than once per week.

    FCSO changed the wording to say "would not expect HCPCS code G0250 to be billed more than once in a 30 day period." Which if you follow the 4 tests not more than once per week it can be 29 days not 30. I have to send in for review when that happens.

    We have trouble with the commercial carriers. Some pay the G0250 and some don't. Still trying to resolve that problem.

  6. Default G0250
    Why is the place of service the office when the patient is physically located at home?

  7. #7
    San Antonio
    Default G0250
    Has anyone figured out what POS Medicare is looking for? My denial is for POS. I have the correct dx code as per their guidelines. Do I need to use POS 12????
    Rey Gross, CPC, CMRS

  8. Default
    I would think the POS is 11 because the physician is performing his/her service in the office not at the patient's home.

    And I'm not clear on the number of units, the guidelines say that billing units of service include four tests, so would only one unit be billed?

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