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Posted By angie on 02-14-2019, 16:33:58 in Ob-Gyn
We are billing G0101 for breast and pelvic exam. If the patient has GYN issues that are addressed we bill a E/M along with this with a modifier 25. Medicare all of a sudden are stating we can't bill both on same day. Why would this be the case? We are billing for services performed outside the breast and plevic exam and are attaching the dx codes to the e/m for the services.
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Posted By Melanie Witt on 02-18-2019, 16:31:32
Nothing has changed and while 99212 is bundled into G0101, a modifier is allowed to bypass the edit (in this case the -25 you used). Challenge the denial but be prepared to submit documentation for this visit as well.
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