tci Outpatient Facility Coding Alert - 2017 Issue 4

Reader Question: Make Sure You're Clear on Advance Care Planning Payment

Question: Our physician saw a patient for advance care planning and reported 99497 for the service. We waived the deductible and coinsurance per Medicare rules, but then our payer said that the patient should have paid the coinsurance. Our surgery center doesn’t commonly bill this code, so we aren’t sure what we’re doing wrong. Supercoder.com Subscriber Answer: It’s likely that you administered the advance care planning by itself or with a problem-based E/M service (e.g., 99213) and not with an annual wellness visit (G0438 or G0439). Medicare only waives the deductible and coinsurance...

To read the full article, sign in and subscribe to tci Outpatient Facility Coding Alert.


TCI's Outpatient Facility Coding Alert helps your facility stay profitable by covering issues that are important to you — everything from billing strategies and appropriate payment indicators to coding tips and tricks, analysis of industry trends, and so much more. Subscribe today and let our experts make your job easier.

  • Current newsletters added each month
  • Fully searchable archives - over 650 articles
  • ALL years/issues back to 2012 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Outpatient Facility Coding Alert +Archives

free demo
request yours today
pricing
for any budget
sign IN
welcome back!