Medical Billing Forum

Billing => Billing => : AllAboutU August 28, 2015, 08:10:18 PM

: Texas Medicaid Well Checks
: AllAboutU August 28, 2015, 08:10:18 PM

Good Afternoon all

I have a Pediatric agency that called with a ? on their billing. Pediatric's isn't my specialty so im looking for help. They are billing ICD-9 V20.2 with CPT's 92587 and 99173 to Texas Medicaid. 99173 is being denied as not a benefit of Medicaid, but it is required to bill. I called TMHP and they state the 99173 not a benefit effective 4/1/2010, and they cant tell me how to bill. Can anyone offer any assistance at all? Is there a different code? I have gone through all the manuals I can find, I can not find the current CPT for them. Please help :-)

Thank you

: Re: Texas Medicaid Well Checks
: Michele August 30, 2015, 07:35:46 PM

I'm not familiar with it but what I'm finding is that it is required to be billed, however it is non payable as it is considered included with the physical.  Does that make sense?

: Re: Texas Medicaid Well Checks
: AllAboutU August 31, 2015, 11:39:19 AM

Thank you Michele. That's how I understand it too, but the provider feels they should be reimbursed for all services. I appreciate the help.