Anybody else having issues with Medicaid denying add-on codes such as 11101 or 17003? They are paying the primary code but not the add-on. What is…
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Tag Archives: denying
Humana is denying my cpt 20610
We bill 20610 all the time to Humana and Medicare with many different Dx codes but all of a sudden Humana is denying then when billed with dx M67.811 and all the other codes in that dx family. I have checked the CMs website and there isn’t a LCD code listing for this cpt. Can any one help me?? Have called Humana but I find whenever I call them it is a waste of my time and don’t get clear information that makes any sense.
COB- Secondary denying claims Primary already applied to deductible
I have a current OB patient who has BCBS as primary and Aetna as secondary. She has been seen for multiple office visits [99211] above her routine maternity visits due to a complication of her pregnancy. Her BCBS insurance has applied each of these visits to her deductible. When sent on to Aetna they have been denied as included in the global maternity billing and Aetna states the patient’s responsibility is zero. We are appealing this decision [as these visits should not be included in the global]. But if their decision stands, are we forced to take the write-off because we are contracted with them and eat the cost for the visits?
Medicare and MA plans denying 80307
Our office performes presumptive drug testing on our pain management patients in our in house lab, we send out for definitive results. This year we are now filing 80307 for these presumptive drug screens. I’ve gotten a good many denials from Medicare and Medicare Advantage plans with the reason "This service is not covered by Medicare". Is anyone else having issues getting Medicare to pay and do you know the reason? Is there some kind of modifier we should be putting on these? I don’t think we did with the G code we used prior to 2017. Help!!
Medicare denying 36471-RT and 36471-LT
Medicare is denying 36471-RT and 36471-LT on the same day as CO151 Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.
Our doctor did sclero on multiple veins, same leg on both legs on the same day. The rep at FCSO Medicare is saying only one unit per day for 36471 and suggested to resubmit the claim with appropriate modifier. But I am using the RT and LT. Didn’t think I should use 50 modifier because it isn’t exactly the same on both sides. Do I need a 59? Any suggestions?
Thank you,
Leslie
Medicare is denying the 3D mammo codes
I am needing help with a medicare denial. Medicare had been paying the 77061, 77062, and 77063, but for some reason they are now denying them. I know that the CAD part of a mammo is supposed to get deleted, but that isn’t supposed to happen until January. Can anyone give me some info on why they would deny the 3D? Thank you in advance!