Website maintenance is scheduled for Saturday, October 12, and Sunday, October 13. Short disruptions may occur during these days.
The Centers for Medicare & Medicaid Services recently issued further instructions for contractors processing claims for the preventive medicine benefit for alcohol misuse counseling, which was added last fall. If a claim is submitted for code G0443 (brief face-to-face behavioral counseling for alcohol misuse, 15 minutes) when there are no claims for code G0442 (annual alcohol misuse screening, 15 minutes) in the prior 12 months, the contractor will deny the claim for G0443. The article also reminds contractors and physicians that Medicare will only pay for up to four G0443 services within a 12-month period. Claims for G0443 that exceed that four session limit in a 12-month period will be rejected.
Some other reminders about these services:
You can find further details on this and other preventive medicine benefits covered by Medicare Part B in Chapter 18 of the Medicare Claims Processing Manual.
Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.