I agree. You would only report G1011 when an AUC consultation was done using a specific Clinical Decision Support Mechanism that has been approved by CMS, but for which a HCPCS code has not yet been issued.
If you are reporting modifier MH there would be no G code reported, because MH says you don't know whether the ordering clinician consulted a CDSM. The modifiers go on the line with the CPT code for the service.
I would ask the billing system vendor to make it possible to submit claims with a zero charge for these codes.
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David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
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Original Message:
Sent: 01-15-2020 11:26
From: John Griffith
Subject: AUC/CDS Medicare
I don't believe you should be reporting a G code with the modifier MH. A G code should only be used with modifier ME, MF or MG is my understanding of how to bill.
John Griffith
Administrator
Original Message------
We are currently using a MH modifier for Medicare, and we are using the G1011. I was wondering if anyone is using .01 cent for the G1011 for amount and then writing that off once it has been billed to Medicare. The G1011 is for reporting purposes only, but we have to have an amount in order for it bill to Medicare. I know with the MIPS, we have 0.00 on the measures. We use a registry for this reporting and it is not a problem.
Thanks
Melisa
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Melissa Wissler
Office Manager
Richmond Radiologists, Inc.
Richmond IN
(765)966-2929
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