Author Topic: hha billing  (Read 2114 times)

Tsaav

  • Newbie
  • *
  • Posts: 9
hha billing
« on: November 20, 2009, 10:55:58 AM »
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, 11:03:50 AM by Tsaav »

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4765
    • Solutions Medical Billing
Re: hha billing
« Reply #1 on: November 20, 2009, 06:33:39 PM »
99600 is an unlisted home visit code and that may be the problem.  Medicaid varies by state.  What is the denial stating?

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Tsaav

  • Newbie
  • *
  • Posts: 9
hha billing
« Reply #2 on: November 23, 2009, 10:40:15 AM »
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

  • Hero Member
  • *****
  • Posts: 4254
    • One Stop Resources & Networking for Medical Billers
Re: hha billing
« Reply #3 on: November 23, 2009, 04:56:44 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
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Tsaav

  • Newbie
  • *
  • Posts: 9
Re: hha billing
« Reply #4 on: November 30, 2009, 10:28:31 AM »
Thanks, I'll give them a call.

Tsaav

  • Newbie
  • *
  • Posts: 9
Re: hha billing
« Reply #5 on: December 01, 2009, 10:34:46 AM »
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

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4765
    • Solutions Medical Billing
Re: hha billing
« Reply #6 on: December 01, 2009, 07:00:12 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
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

PMRNC

  • Hero Member
  • *****
  • Posts: 4254
    • One Stop Resources & Networking for Medical Billers
Re: hha billing
« Reply #7 on: December 04, 2009, 04:57:50 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
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com