Hi, I work for an FQHC and I am receiving multiple denials from our MCO’s for "bundling" when I submit an EM level with any other code. Example, 99213 with 99406 (for smoking counseling), J3420 (B12), 90715 (Tdap) Doesn’t matter what the providers have added to the claim, they deny for bundled services. I am so confused.
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Tag Archives: fqhc
FQHC and G codes
Hello,
I have billed G0468 and Medicare is denying our claims because a qualifying visit is not listed on the claim.
The qualifying code choices are G0402, G0438 or G0439. Does Medicare pay for both a G0468 and a qualifying code on the same claim?
I have billed G0468 and Medicare is denying our claims because a qualifying visit is not listed on the claim.
The qualifying code choices are G0402, G0438 or G0439. Does Medicare pay for both a G0468 and a qualifying code on the same claim?
(Are these to be billed with a fee or a $ 01 to get them on the claim so Medicare sees the code).
Thanks!
Fqhc vaccine billing
How are you billing for vaccines if the patient does not see the provider?
Bill admin and vaccines, no E/M code.
Thanks
fqhc billing place of service
Hello everyone! i am new to FQHC billing. I live in the state of Alabama.
MY question is
our practice bills medicare medicaid and alot of commercial insurances. When we bill to medicare and medicaid how do we know whether to use place of service 50 (fqhc) or 11 (office).
Example ::: pt comes in with medicare and bcbs. does medicare go to place of service 50 and bcbs go to place of servie 11?
Example ::: medicare and medicaid. do we bill both with place of service 50 or medicare to 50 and medicaid to 11??
Does all commercial just go out with place of service 11???
Quite confused. Any and all help will be greatly appreciated.
Tina
Step Outside Your Coding Bubble into FQHC Services
Compare coding and billing for FQHCs to that of provider- and facility-based organizations. Federally qualified health centers (FQHCs) account for less than 10 percent of designated organizations, but as coding professionals we should understand the differences between FQHCs and physician- or facility-based organizations. Note: Medicare, Medicaid, and commercial carriers do not all process FQHC claims […]
The post Step Outside Your Coding Bubble into FQHC Services appeared first on AAPC Knowledge Center.
FQHC CMS Guidlines
Good Afternoon,
I currently work for an FQHC and I am trying to pinpoint the CMS guidelines for physician documentation. Does anyone know the time table or the exact location where it states when they want the chart signed and locked? Thanks
FQHC Coding – Telehealth – Medicaid
Hello,
Can FQHCs bill for Telehealth for Medicaid patients? I know according to Medicare guidelines we are not authorized to provide distant site services. And because we are located in a Metropolitan area we cannot bill for an originating site. I found a very outdated unclear guideline for Medicaid but I would like confirmation.
Thank you,
Lauren Lomax
FQHC Coding – Telehealth/Prolonged Services/Chronic Care Management
Hello,
I am new to working for an FQHC and my facility would like to start billing for telehealth services starting 2019. However I keep finding conflicting information on the NY Medicaid website and MLN on whether or not we are qualified to bill for distant/originating sites. We are located in Brooklyn, NY. Can anyone please shed some light on the requirements needed to bill for telehealth, specifically telepsychiatry.
https://www.health.ny.gov/health_car…5/mar15_mu.pdf
https://www.cms.gov/Outreach-and-Edu…rvcsfctsht.pdf
https://www.cms.gov/Outreach-and-Edu…cfactsheet.pdf
Also can FQHC’s bill for Prolonged Services with direct patient contact? I read the PDF I put above and it is not included, however they define FQHC visits as "A FQHC visit is a medically-necessary medical or mental health visit, or a qualified preventive health visit. The visit must be a face-to-face (one-on-one) encounter between a FQHC patient and a FQHC practitioner during which time one or more FQHC services are furnished. "
Are you all billing for Chronic Care Management? I am trying to get it implemented here but they are saying it will be hard to enforce and hard to track. Do you have any tips?
Thank you,
Lauren
FQHC Coding – Telehealth/Prolonged Services/Chronic Care Management
Hello,
I am new to working for an FQHC and my facility would like to start billing for telehealth services starting 2019. However I keep finding conflicting information on the NY Medicaid website and MLN on whether or not we are qualified to bill for distant/originating sites. We are located in Brooklyn, NY. Can anyone please shed some light on the requirements needed to bill for telehealth, specifically telepsychiatry.
https://www.health.ny.gov/health_car…5/mar15_mu.pdf
https://www.cms.gov/Outreach-and-Edu…rvcsfctsht.pdf
https://www.cms.gov/Outreach-and-Edu…cfactsheet.pdf
Also can FQHC’s bill for Prolonged Services with direct patient contact? I read the PDF I put above and it is not included, however they define FQHC visits as "A FQHC visit is a medically-necessary medical or mental health visit, or a qualified preventive health visit. The visit must be a face-to-face (one-on-one) encounter between a FQHC patient and a FQHC practitioner during which time one or more FQHC services are furnished. "
Are you all billing for Chronic Care Management? I am trying to get it implemented here but they are saying it will be hard to enforce and hard to track. Do you have any tips?
Thank you,
Lauren
FQHC E/M for VFC encounter
I have a question. Our provider wants to bill an office visit 99212 when administering VFC vaccines such as the flu shot. We brought up the issue of medical necessity and also that a 99212 is a problem focused e/m and the patients only coming in for the vaccine with no problem. He just wants paid the encounter rate, but yet doesn’t want to have to see the patient either. I do not believe this is allowed red flag for fraud and abuse. Can some clarify. I feel it’s not allowed. If he wants the encounter rate so bad then he needs to see the patient and counsel them on the vaccine and document what he counseled and do a physical exam on the patient.