States Applicable to Alert: Hawaii, Nevada, American Samoa, Guam, the Northern Mariana Islands and California.
Background Information: This alerts physicians to issues with claims processed from January 1, 2009, through April 8, 2009 with new IPPE CPT Code, G0402. This code was to be excluded from the beneficiary’s deductible. However, claims processed during this time period were processed with the amount being applied to the beneficiary’s deductible.
Applicable Codes: G0402 – 2009 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment.
MAC Action: Our system was updated with the correct information effective with the claims cycle of April 8, 2009. Palmetto GBA previously identified claims where the deductible was applied to G0402 in error. A mass adjustment was completed on June 30, 2009, for the J1 environment.
Provider Action: None required.
Date Reported: June 12, 2009
Date Resolved: June 30, 2009