Author Topic: CPT 93000 denied for absence of Ordering physician information  (Read 6046 times)

Sriram_Sub

  • Full Member
  • ***
  • Posts: 126
CPT 93000 denied for absence of Ordering physician information
« on: January 24, 2013, 11:52:44 AM »
Hi,

     I work for a family practice provider now and she has done EKG's (CPT 93000) to patients at the time of their office visit itself. I have received denials from Medicare stating N265 and N286 (Missing / Invalid Ordering / referring physician identifier). I am thinking of resubmitting all such denied claims with the rendering provider's name added as referring provider as she was the one who ordered it. Will that work? If not, what else should I do?

Regards
Sriram
Sriram

RichardP

  • Hero Member
  • *****
  • Posts: 757
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #1 on: January 24, 2013, 02:27:08 PM »
The following is true for us, so I assume it is true for you:

For Medicare billing, for every Medicare patient  - every HCFA form must have the referring doctor's name in Box 17 and that doctor's NPI number in Box 17b.  That is, even if there is no outside referral, and even if it is just an uncomplicated office visit, the name and NPI number of the doctor who saw the patient must go in those boxes.  The NPI number in Box 17b must be the same number that is in Box 24J.

Some background follows, in case it is useful to you.  From here:  http://www.medicalbillinglive.com/members/index.php?topic=7045.msg21031#msg21031

Doctors groups may hire physicians and pay them a salary.  A doctor who has incorporated may hire physicians and pay them a salary.  A doctor acting as a sole proprietorship may hire physicians and pay them a salary.  All work done is billed under the name of the hiring group or physician.  The hiring group or physician gets paid and then pays the hireling(s) a salary.

One of the points of the NPI numbers was to make this relationship more clear to CMS.  Hence the Type 1 (who did the work) and Type 2 (who gets paid) NPI numbers.  Both must be used on the CMS 1500 form that is submitted to Medicare.  One tells CMS who did the work, and the other tells CMS who gets paid.  In the case of a solo practitioner, both of the NPI numbers provided on the CMS 1500 form belong to him.  In the case where the work was actually performed by a hireling, the CMS 1500 form must contain the Type 1 NPI number for who did the work (the hireling), plus the Type 2 NPI number for who gets paid (the hirer).

On the CMS 1500 Form, the Type 2 NPI number for who gets paid goes in Box 33.  The Type 1 NPI number for who did the work goes in Box 24J.  The Type 1 NPI number for the referring doctor goes in Box 17a.  This is how we do it and we have no problems getting paid.
« Last Edit: January 24, 2013, 02:36:14 PM by RichardP »

mainiaDup

  • Sr. Member
  • ****
  • Posts: 260
    • dapoxetine tablets buy online india
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #2 on: November 07, 2022, 08:12:38 AM »
Diabetes metabolism research and reviews <a href=https://priligy.me/>emla cream and priligy tablets</a> baumannii during 2 h increased bacterial killing by 5 and 25, respectively

unorgobug

  • Sr. Member
  • ****
  • Posts: 330
    • doxycycline ruined my life
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #3 on: November 16, 2022, 03:04:54 AM »
Acyclicity developed in raloxifene treated rats at a frequency similar to vehicle treated animals Table 1 <a href=http://doxycycline.world/>doxycycline 100 mg for sale</a>

royagma

  • Sr. Member
  • ****
  • Posts: 326
    • generic of furosemide bad for your kidneys
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #4 on: November 23, 2022, 01:06:11 PM »
<a href=http://lasix.autos/>lasix without prescription</a> But because the polymer notes will be thinner, cash machines will be able to stock more, and operators say the machines will be less likely to jam

Medical Billing Forum

Re: CPT 93000 denied for absence of Ordering physician information
« Reply #4 on: November 23, 2022, 01:06:11 PM »

Vogegrorb

  • Sr. Member
  • ****
  • Posts: 334
    • is levitra still on the market
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #5 on: December 09, 2022, 11:05:07 AM »
viagra neurontin mg sizes Natural gas, the cleanest of the hydrocarbon based fuels, has long been a primary choice for heating and power generation, as well as an essential raw material, or Гў <a href=http://clevitras.cyou>levitra sample online pharmacy</a> Prostate specific antigen PSA level age adjusted normal range 4

awaixebra

  • Full Member
  • ***
  • Posts: 239
    • taking 2 cialis pills at once
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #6 on: December 10, 2022, 10:01:05 PM »
Several very large studies are in progress to assess the potential of aromatase inhibitors in the adjuvant setting <a href=http://vlasixs.cyou>lasix drug interactions</a>

lapound

  • Sr. Member
  • ****
  • Posts: 340
    • do you have to use finasteride forever
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #7 on: December 11, 2022, 03:46:43 PM »
2021 Dec 23; 10 1 1 <a href=https://nolvadex.mom>tamoxifen versus raloxifene</a>

piegmen

  • Sr. Member
  • ****
  • Posts: 326
    • durjoy dapoxetine hcl
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #8 on: December 16, 2022, 04:50:44 AM »
<a href=https://sviagrass.monster>pills like viagra over the counter</a> 2012 Jul; 33 4 679 88

Faispom

  • Sr. Member
  • ****
  • Posts: 322
    • cialis time to be effective
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #9 on: January 26, 2023, 06:08:44 PM »
<a href=http://propecia.bond>fincar 5mg</a> Hölttä T, Gordin D, Rahkonen O, Turanlahti M, Holmström M, Tainio J, Rönnholm K, Jalanko H 2020 Good long term renal graft survival and low incidence of cardiac pathology in adults after short dialysis period and renal transplantation in early childhood

Medical Billing Forum

Re: CPT 93000 denied for absence of Ordering physician information
« Reply #9 on: January 26, 2023, 06:08:44 PM »

astonry

  • Jr. Member
  • **
  • Posts: 99
    • clomid twins
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #10 on: January 27, 2023, 09:12:21 AM »
World J Surg Oncol 4 67 <a href=https://lasix.mom>buy lasix online cheap</a>

ideorrert

  • Sr. Member
  • ****
  • Posts: 304
    • liquid clomiphene dosage
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #11 on: February 03, 2023, 12:33:41 AM »
Faigenbaum, A <a href=http://lasix.mom>lasix 100mg</a>

uttessy

  • Sr. Member
  • ****
  • Posts: 338
    • cialis bathtub advertisement
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #12 on: February 04, 2023, 01:32:37 PM »
<a href=http://propecia.bond>finasteride 1 mg</a> Alli diet pills eBay s raise in the process of the body, increasing metabolism in the body s metabolic rate, aiding burning fat

Appoink

  • Full Member
  • ***
  • Posts: 182
    • how much is real cialis in canada
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #13 on: March 07, 2023, 11:55:25 AM »
<a href=https://buycialis.buzz>cialis without a prescription</a> They found that ALND decreased axillary recurrence at 10 years 5

Coogincot

  • Full Member
  • ***
  • Posts: 156
    • can magnum trt be taken with cialis
Re: CPT 93000 denied for absence of Ordering physician information
« Reply #14 on: March 07, 2023, 07:21:27 PM »
They still did not answer the question What is a better strategy to treat upfront or wait till you develop osteoporosis or osteopenia and then treat <a href=https://buycialis.buzz>5 mg cialis generic india</a>

Medical Billing Forum

Re: CPT 93000 denied for absence of Ordering physician information
« Reply #14 on: March 07, 2023, 07:21:27 PM »