I am getting denials from a Medicare Advantage Plan stating CLIA Certification Level not met. I can not get clear information from carrier. Any suggestions/help would be appreciated. Thank you
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Tag Archives: Denial
BCBS Denial of 99213-25 with 98940/98941
I am New to Chiropractic billing and the provider is receiving denials for his established E/M visits when billed with a 98941-98942. New patient visits are paid with no issues, correct -25 modifier is being used, separate and billable diagnosis are used. Any suggestions?
Thank you for any help!
Thank you for any help!
27096 denial
Hi, we came across the denial from highmark PA for 27096 denying for invalid modifier. claim was submitted with 50 modifier and then I resubmitted with RT LT still insurance keep denying for same reason. please help.
Inpatient – Telepsychiatry counseling appointments – denial from Medicare
Does anyone know the revenue code for billing the CPT code (90834) on a UB04? Would it happen to be 0780 or 0789?
The facility is Part A Medicare Provider and all their claims were rejected. They are located in FL. Would we have to call Medicare in FL to find out how to reprocess these claims. If anyone has a phone number to share that would be very helpful.
I have looked all over the internet and was not able to find how to bill this correctly.
Thank you.
Clarification for denial (76641/76642)
I’ve recently been having problems with insurances paying for 76641/76642 when billed together. I use modifier -59 on CPT 76642. This hasn’t been an issue in the past, within the last month or two my claims has been denied.
Any help, suggestions are welcome please advise.
Any help, suggestions are welcome please advise.
Thank you
Denial CO-252
Hi All
I’m new to billing. I’m helping my SIL’s practice and am scheduled for CPB training starting November 2018.
Can someone explain to me what denial CO-252 means and how to resolve it? Is there a website I can visit that would explain more on denials/rejections and how to resolve them?
Any assistance would be greatly appreciated.
Thank you
Michelle
Therapy codes denial for SNF
Just got a denial from UHC on outpatient therapies i.e occupational and speech, The reason code stated that it is not billed according to the Medicare guidelines. The codes in question are 92526 and 97535 both of em had GN and GO modifiers appended to em respectively but the 92526 also had KX modifier. Adding to that I had the same bill for the same patient for the same procedures but different dates and that one got paid and the only difference was it didn’t have any KX modifier with 92526.
AAPC Launches Denial Resolution Training
Become an expert in identifying, correcting, and preventing denials. Denied claims are as common and predictable as having a child spike a fever before a big holiday, and every practice or group finds itself wrestling with corrections and resubmissions. But if you ask AAPC’s Director of Curriculum Katherine Abel, CPC, CPB, CPMA, CPPM, CPC-I, AAPC […]
AAPC Knowledge Center
E/M denial
Good morning,
I am looking for some advice on the following scenario and would appreciate any help you could offer. I am receiving a denial on a patient that received a pic line insertion in the morning and was seen by a different provider later that day for an E/M. The E/M is being denied by the payer. Any thoughts on what the correct modifier should be on the E/M? Obviously, 24 wont work because the two visits were with different providers. Any suggestions?
Thank you.
I am looking for some advice on the following scenario and would appreciate any help you could offer. I am receiving a denial on a patient that received a pic line insertion in the morning and was seen by a different provider later that day for an E/M. The E/M is being denied by the payer. Any thoughts on what the correct modifier should be on the E/M? Obviously, 24 wont work because the two visits were with different providers. Any suggestions?
Thank you.
99397 denial because of gyno exam
Anthem has been denying our 99397 for max benefits, and when our follow-up girl investigates it, she is finding that the patient’s gynecologist has already billed 99397 this year. Is this just an error on Anthem’s part, not acknowledging the diagnosis codes associated with the gyno exam and our primary care preventative exam? Is there something we should be doing differently on our end from a coding standpoint?