I have been billing CPT code 76700 with CPT code 93975 for ultrasounds and using only the 59 modifier. Recently, Blue Cross Blue Shield and Humana have stopped paying for these. Is this because I don’t use modifier 26? Or perhaps we need separate diagnosis codes for each CPT code? Can someone please advise. Thank you.
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Tag Archives: paid
CPT 91035 is not being paid by the majority of the insurance companies- Why?
CPT 91035 is not being paid by the majority of the insurance companies. We need to find out how to get this CPT code paid. Do we need to add a modifier, obtain additional prior auths? This is usually billed with CPT 43235. Even when its billed by itself it is being denied. Anyone knows what happen here?
CPT 91035 is not being paid by the majority of the insurance companies- Why?
CPT 91035 is not being paid by the majority of the insurance companies. We need to find out how to get this CPT code paid. Do we need to add a modifier, obtain additional prior auths? This is usually billed with CPT 43235. Even when its billed by itself it is being denied. Anyone knows what happen here?
cpt 34812.. How to get this paid?
Hi, is there any way I can get this add-on code 34812 (open, artery exposure) paid without my surgeon assisting or doing the main procedure cpt 34705 (endovascular aortic repair) which was done by the other surgeon? My manager explained it to my doctor that 34812 was revised and it is now and add-on code. My doctor only did the artery exposure for the other doctor and left the room after that.
Could someone please guide me on how I can get this paid?
Thank you.
Code Knee Orthoses Right to Get Braces Paid
Knee orthoses are one of the highest sources of errors, a letter from CGS to providers warns, and the Medicare Administrative Contractor’s (MAC) wants providers to be more careful with documentation and reporting. How Do We Get Paid? The Centers for Medicare & Medicaid Services (CMS) requires medical necessity for the diagnosis or treatment of the […]
AAPC Knowledge Center
Getting paid for units for 26356 25260
I submitted a claim to MN Medical Assistance for tendon repair. He repaired multiple tendons in the forearm and hand. I submitted 26356 with 3 units (MUE is 4) and 25260 with 3 units (MUE is 9). MN MA only paid for one unit for each. When I called them they said they only allow one unit for each. Period. I said no way the description says each tendon. Nope we only allow one unit. I asked if I can resubmit on multiple lines and she said won’t make a difference. So do I call and try to get a different representative who might be a little more helpful or has anyone else experienced this. The physician is going to want proof of some sort why they will only pay for one unit. Any insight is greatly appreciated.
Deb
how to get cpt 99367 paid
In the last 6 months I have billed 99367 18 times to Work comp. in CA and none have been paid. What is the secret? Does this code ever get paid?
CMS Improperly Paid Physical Therapists Millions
A medical review conducted by the Office of Inspector General (OIG) found 61 percent of claims (out of 300 sampled) for outpatient physical therapy services did not comply with Medicare medical necessity, coding, or documentation requirements. Although the Centers for Medicare & Medicaid Services (CMS) generally disagreed with OIG’s findings, a review of the requirements […]
AAPC Knowledge Center
D68.32 Won’t Get You Paid for Blood Clotting Factor
Medicare Part A claims that include ICD-10-CM diagnosis code D68.32 Antiphospholipid antibody with hemorrhagic disorder will be denied after June 30, 2018, when the code is terminated. Per the Inpatient Hospital Billing Manual, Chapter 3, Section 20.7.3, Payment for Blood Clotting Factor Administered to Hemophilia Inpatients, effective July 1, 2018, payment may be made for […]
AAPC Knowledge Center
Getting paid for LARC insertion immediately after delivery?
Will a provider get paid for LARC insertion immediately after delivery? It is my understanding that this was considered part of the global package in the past. Now, I want to make sure in Georgia that it is paid outside of the global. Can anyone assist me? Thanks!!