Medical Billing Forum

Billing => Billing => Topic started by: billspecial01 on February 12, 2018, 06:47:23 PM

Title: 90471 being denied, please help
Post by: billspecial01 on February 12, 2018, 06:47:23 PM
Hi I bill for a family practice. We are getting denials from Ambetter/Superior Health for our 90471 code. Here's an example

99214 25 mod Diag 1234
90674  dx 3(Z23)
90471  dx 3(Z23)

They will pay the 99214 and 90674 and deny the 90471 as Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided.

Ive contacted them and they tell me we need to bill it correctly and of course they cant tell me how to bill. Im not sure what I'm doing wrong, can anyone help? thank you
Title: Re: 90471 being denied, please help
Post by: Michele on February 14, 2018, 11:44:14 AM
The 90471 is appropriate.  I know that they can't tell you how to bill it but do they have any documentation (memos, bulletins) that explain how they expect the flu shot to be billed?  Most carriers post something somewhere about how they want the flu shot coded.
Title: Re: 90471 being denied, please help
Post by: billspecial01 on February 15, 2018, 09:42:36 AM
I will look for it. Thank you  :)