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Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Billing Medicare Wellness with office visit

I work for a group of family practice providers. One has asked me if he could charge a subsequent Medicare wellness visit (G0439) with a NEW patient office visit (99204) for the same encounter. Commercial payers will let me charge an office visit with a NEW patient wellness visit, BUT ONLY IF the office visit used is an established code (ex: 99386+99213=OK; 99386+99203=NOT ok). Is Medicare the same? That is, G0439+99213=ok, but G0349+99203=NOT ok? I haven’t found any CMS policy one way of the other on this, it’s just how I was trained. If you know the answer, great! If you have a reference, even better. (This particular provider wants very much to document and code properly, but he’s very much into "prove it to me/show me the guideline.") Thank you,

Medical Billing and Coding Forum