Hello,
I am wondering if anyone else from Ohio is having an NDC issue with Depo Injections (J1050) when billed to any of the Ohio Medicaid HMO’s, primarily Caresource.
Thanks!
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Tag Archives: invalid
invalid codes
I have been denied level of service 99203 because the dx used is D22.5 and D18.01
Does anybody know if these two can’t be used together and if so, where is this documented?
Thanks
Invalid Medicare Codes
Hello,
I am new with billing Medicare and know that S0020 is consider "invalid" or non-covered for Medicare. Any suggestions on an alternative code that may be appropriate for Medicare? The physician performed the following:
99214
20610
J1030
S0020
J2001
Any advise is greatly appreciated. Thanks!
Invalid diagnosis, need help please…DERMATOLOGY
Hello, I have a denial for invalid diagnosis code. But I’m having a hard time pinning down which one is invalid. They are as follows:
L24.9-Irritant contact dermatitis, unspecified case
L98.1-Factitial dermatitis
L90.5-Scar conditions and fibrosis of skin
D22.5-Melancytic nevi of trunk
I may be overlooking it, but none of these stand out to me, except the L98.1. But in this case, the intended diagnosis isn’t "skin picking disorder" so the F42.4 wouldn’t apply. Anyone else see something I’m not?
Thanks,
J Wilson :confused:
Tricare refunds due to invalid NDC
Someone familiar with Tricare billing: Please Help!
A few months ago, our practice began receiving multiple Tricare refund requests due to "the recommended drug/vaccine dosage for the National Drug Code (NDC) units from the manufacturer has been exceeded."
The claims listed were from 2013-2016 and totaled thousands of dollars. I was taught to report the NDC#’s as 5-4-2 format and each vaccine = 1 unit. Our software doesn’t support this so I have to manually enter these claims directly into MyTricare.com. I’ve contacted Tricare by phone and letter, but they only direct me to their online guidelines which appear to validate what myself, and the person before me, billed. When I called for help, I was told to refer to the FDA’s website because Tricare doesn’t have a list of vaccines and how they should be reported.
We have no choice but to refund this money, but I want to know what I’m doing wrong so this doesn’t happen again in another 3 years. Tricare is the only insurance that claims we are overbilling.
Thank you in advance to anyone who can help explain this to me.
NDC# denied as invalid for TDAP and Prevnar
In the past month, our practice (primary care) started getting denials from Medicare and Bcbs for TDAP vaccine (NDC 49281-0400-15) and Prevnar vaccine (NDC 00005-1971-02), stating invalid NDC code. We had not changed anything in our system and have verified the numbers on the vaccine box and it is correct. We have researched online and cannot find that anything has changed. Now, we are starting to receive NDC denials from other insurances-UHC, Aetna, etc. I have called several insurance companies and all they tell us is that it is invalid. Help!