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I work for a medical practice and we have a few patients that receive 2000mcg of B12. I am aware the Medicare only covers 1000mcg but is there a way to bill the claim to Medicare so they will cover 1000mcg and deny the other 1000mcg of B12. Our claims are not making it through to Medicare. I really appreciate the help!
This is how the the claims are billed to Medicare:
J3420/59
J3420/59
96372
96372
Getting more involved with your local AAPC chapter involves little steps and does not mean that you have to make a huge commitment to the chapter. There are a lot of benefits to getting more involved in the chapter, including meeting more AAPC members and increasing your network, earning points that might enable you to […]
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The 2019 CPT® codebook will include six new codes in the range 111xx to describe tangential biopsy, punch biopsy, and incisional biopsy. Two codes describe tangential biopsy: the first code describes biopsy of a single lesion, and the second (add-on) code describes each additional lesion biopsied, beyond the first. A tangential biopsy is performed with […]
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If you’re interested to learn more about the 2019 Medicare Physician Fee Schedule Proposed Rule, you’ll get your chance on Monday, August 27. The Centers for Medicare & Medicaid Services (CMS) will host a webinar that day, from 2:00-3:30 p.m. (Eastern time). The planned overview of the 2019 Medicare Physician Fee Schedule Proposed Rule will […]
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Normally, I would have chosen the DOS to be 10/31; however per this article (& test) it should be 11/1.
What are you using? The date of starting time or the date of end time?
This totally blew my 22 years of experience out of the water. Have I been mis-informed for all these years? :confused:
In most cases, the appropriate date of service when services last more than one day is the day the service concluded. Radiology services typically have two components: professional and technical. The DOS for the technical component is the date the patient received the service. Professional claims for “reading” are billed the day the physician provided […]
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this is going to be my most detailed question yet ….
I’m not the normal hospital coder and i don’t normally handle insurance pre-qualifications… ok — i don’t do this at all, but i’m the only one left in the building thats a coder.
We have a Pt that has had sepsis (staph susceptible to methicillin) and had surgery at a different facility for the infection in he proximal left thumb.
He is DMII and not sure if it a complication from DMII or not .. records are pending from the other facility. (i think it is — but)
The Pt wants us to continue his care and the our surgeon has debride’d (irrigation yatta yatta) the wound and applied a synthetic skin graft … the graft was a free sample.
We are now wanting to apply another graft to same site …. probably going to be another debridement …
Insurance will deny an unspecified wound left thumb …
and i wanted to code still the sepsis staph type A (im going on memory the next morning — just got in)
The surgeon stated it as a wound .. but i think that is more of an abscess now .. and should be tested again for staph …. We don’t have a lab for staph in our records yet….
anyways ,,, i’m thinking L02.511 and adding history of staph for the insurance pre-qualification
Sorry that i’m not more knowledgeable here …
Ever since the 2013-2016 Ebola outbreak in western Africa, vaccines are being developed; however, there are still no vaccines or drugs that have been approved by the U.S. Food and Drug Administration (FDA) to fight it. The good news is the World Health Organization (WHO) published information about a collaborative Ebola vaccine effort between the […]
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Most all of the ob/gyn docs I work for have a number of patients that are requiring more than the global 10-13 antepartum visits for their care. Whether it be for poorly controlled gestational diabetes, pre-existing dm, drug abuse, etc., how does anyone out there bill for these extra visits and get them paid successfully? Please advise.
Thank you!
Part 2: Applying appropriate modifiers and assigning medically necessary diagnosis codes aids claim reimbursement. Delivering quality care while ensuring effective clinical documentation and compliant medical coding is an ongoing challenge in a fast-paced emergency department (ED). This two-part series reviews best practices for optimizing coding compliance and reimbursement of ED claims. Last month, we explored […]
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