Author Topic: CO-222 and N640 (Read 5805 times)

TXBiller · « **on:** April 16, 2019, 10:48:20 AM »

I need assistance in figuring out what the below is telling me. Any help you can give will be greatly appreciated.

222: Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific. NOTE: Refer to the 835 Healthcare Policy Identification Segment (Loop 2110 Service Payment Information REF), if present.

N640: Exceeds number/frequency approved/allowed within time period.

jenniferp · « **Reply #1 on:** April 16, 2019, 05:27:24 PM »

What kind of CPT are you getting this denial for?

Michele · « **Reply #2 on:** April 17, 2019, 10:55:27 AM »

Quote from: jenniferp on April 16, 2019, 05:27:24 PM

What kind of CPT are you getting this denial for?

Yes, need more information to be able to help.

TXBiller · « **Reply #3 on:** April 19, 2019, 10:09:47 AM »

Sorry about that.

99203 with mod 25 received both CO-222 remark N640
G0444 CO-222 remark N640

kristin · « **Reply #4 on:** April 22, 2019, 08:22:03 AM »

The answer is sort of right there in the denial codes. The services being billed have exceeded the amount allowed in a give time frame.

The provider has already billed a new patient E/M on this particular patient within the last 3 years, so cannot bill another one, and the provider or another provider has already billed a depression screening for this patient in the last 12 months. Medicare only allows one depression screening every 12 months for a patient.

Medical Billing Forum · « **Reply #4 on:** April 22, 2019, 08:22:03 AM »

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