Author Topic: hha billing  (Read 4159 times)

Tsaav

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hha billing
« on: November 20, 2009, 01:55:58 PM »
I was wondering if anyone could help with billing a post hospital visit for a home health agency. ??? I think that it should be 99600 but I get that code denied every time I use it. I am billing to WI state medicaid. Please help...any suggestions will be apperciated. Thanks
« Last Edit: November 20, 2009, 02:03:50 PM by Tsaav »

Michele

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Re: hha billing
« Reply #1 on: November 20, 2009, 09:33:39 PM »
99600 is an unlisted home visit code and that may be the problem.  Medicaid varies by state.  What is the denial stating?

Michele
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Tsaav

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hha billing
« Reply #2 on: November 23, 2009, 01:40:15 PM »
Well they gave me 6 denial codes:

0116 - Procedure Code or Drug Code not a benefit on Date of Service.
0184 - Procedure Code is restricted by member age.
0859 - Modifiers submitted are invalid for the Date of Service or are.
1279 - Procedure not payable for Place of Service.
1280 - Rendering Provider Type and/or Specialty is not allowable for the service billed.
1521 - Procedure Code is not allowed on the claim form/transaction submitted.

I didn't use a modifier on this code. There is one that is for a follow up visit but this wouldn't be a follow up. Should I try with the modifier or should I try T1001 which is a nursing assessment/evaluation under medicaid. Is a PA need to bill the post op visit?

PMRNC

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Re: hha billing
« Reply #3 on: November 23, 2009, 07:56:44 PM »
You have more than a coding error denial, you have to check POS, Patient's age, etc. I would call the carrier with that many reason codes listed.
Linda Walker
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Tsaav

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Re: hha billing
« Reply #4 on: November 30, 2009, 01:28:31 PM »
Thanks, I'll give them a call.

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Re: hha billing
« Reply #4 on: November 30, 2009, 01:28:31 PM »

Tsaav

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Re: hha billing
« Reply #5 on: December 01, 2009, 01:34:46 PM »
Well, they did what they usually do, give me the run around. Seem like the people answering the phone don't really know how to help billers. They don't know anything about billing codes and how to help with the issues at hand. Well with that said, maybe someone can help me. The issue is I am trying to bill for the post hospital visits by my RNs to reinstate our pt's personal care services. This is to WI medicaid. Please help. Let me know if I can or can't bill for this service.

Michele

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Re: hha billing
« Reply #6 on: December 01, 2009, 10:00:12 PM »
Sorry, I don't have any info.  I would try my luck at calling back though.  Each call usually results in a different response and hopefully you will get someone who can help!

Michele
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PMRNC

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Re: hha billing
« Reply #7 on: December 04, 2009, 07:57:50 PM »
Insurance carrier reps will not and cannot help you bill. Their job is to process the claims as presented. I would take your claims and go line by line with the denials. You have several different rejections here it's not just "how" it was billed.
Linda Walker
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Medical Billing Forum

Re: hha billing
« Reply #7 on: December 04, 2009, 07:57:50 PM »