We have several claim that are being denied payment for G0390, Trauma Team Response with the correct Rev Code 689 billed on the same day as CPT 99291, Critical Care. The EOB always says that the CPT/HCPCS is not valid/ correct or that services were not performed. The payer is WV Health Plan Medicaid. I have reviewed the CMS guidelines and it looks like it is being billed/coded correctly. Is anyone else having an issue getting G0390 paid?
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Modifier ST – relation to trauma and injury
Fellow AAPC Professionals:
I am seeing modifier ST appended to radiology services in the outpatient settings for patients who have had an injury. This is happening for United Health Care Choice Plus.
Does anyone have any information on whether this is appropriate use of this modifier for this carrier? Perhaps there is a special incentive for UHC Choice Plus?
Thank you!
G0390 with 99291 Trauma Billing- Help
Does anyone use the G0390 on professional claims? It is in the HCPCs book and per what I can find online it needs to be billed with Level 1 Trauma activation, but only if critical care is performed. Our billing dept is saying the G0390 is only billed on the facility side?
Any help would be greatly appreciated!
thank you,
Jolene
Trauma pain epidurals with medicare
We have some anesthesiologists that due pain blocks/epidurals for acute pain due to trauma. These patients are not having surgery, so post op pain is out the door. When Medicare updated their LCD with the new epidural codes they did not include an "acute pain due to trauma code" that was previously listed. They updated 10/1/17 to include this but any epidurals done for trauma pain over the last year and being denied for medical necessity. Has anyone else encountered this issue? If so, were you able to appeal and get reprocessed? Thank you!
as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses
Hello all,
I need HELP!! One of my physicians came to me asking about the causality reimbursement. He stated they will be required as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses or risk losing reimbursement. Does anyone know what this is about? Thanks in advance
I need HELP!! One of my physicians came to me asking about the causality reimbursement. He stated they will be required as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses or risk losing reimbursement. Does anyone know what this is about? Thanks in advance
Trauma
Hello I am a new trauma coder and would like to know if the trauma provider can get a 92950 (cpr) for participating in the resuscitation on a patient in the ER. He also does critical care
ER versus OP and IP for trauma patients
If a patient is seen in the ER and then taken to the OR for emergency surgery, would you change the place of service to 22 or 21 or leave it as 23.