I work for a group practice where two of the MDs use a separate billing company. That company bills post op visits (99024) to Workman’s compensation carriers with a charge of $ 250.00 and are getting paid!!! Has anyone heard of this? I want to get on top of this before the other MDs catch wind and want to do the same. I do not feel its proper or even ethical, at that, if they are following the rules of CPT. The treatment after the surgery is included in the surgery code for a certain time frame. Any thoughts?
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Tag Archives: Carriers
Billing Post op visits to Workmans comp carriers
I work for a group practice where two of the MDs use a separate billing company. That company bills post op visits (99024) to Workman’s compensation carriers with a charge of $ 250.00 and are getting paid!!! Has anyone heard of this? I want to get on top of this before the other MDs catch wind and want to do the same. I do not feel its proper or even ethical, at that, if they are following the rules of CPT. The treatment after the surgery is included in the surgery code for a certain time frame. Any thoughts?
Carriers that WANT you to add Modifier 51
I know most carriers (especially Medicare) don’t want you to add modifier 51 when multiple procedures are billed. The computer edit systems will do it for you.
I know there are some exceptions. Wellcare, for example, requires providers to add 51 on claims where appropriate.
I am looking for any other carriers that require it to be added to claims
Bonus points for website links and claim policies you can reference.
CPT 63047 and 22630 denials for COMMERCIAL carriers
I am familiar with the CCI Edit for 63047/63048 with 22630 or 22633 and understand how
it applies for work at the same level. My question is are other practices experiencing denials from commercial carriers and are you successfully appealing them? Any updated information on this would be appreciated. Frustrated here in Florida.
it applies for work at the same level. My question is are other practices experiencing denials from commercial carriers and are you successfully appealing them? Any updated information on this would be appreciated. Frustrated here in Florida.
Insurance Carriers Aren’t the Big Bad Wolf
Get an insider’s view into insurance payments and denials and healthcare reimbursements. By Michael Strong, MSHCA, MBA, CPC, CEMC and Tracy Hunt, CPC, CFE Billers, coders, revenue cycle management, and providers often think of insurance carriers as the “big bad wolf.” Having worked for several insurance carriers, we’ve repeatedly heard accusations from providers and their […]
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