Author Topic: 99203-25 with 99385  (Read 3036 times)

datwood

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99203-25 with 99385
« on: July 05, 2013, 02:17:22 PM »
Hi!
We billed a 99203-25 with a 99385 on the same visit (new patient).  The insurance company did an overpayment recovery from our last check due to incorrect payment the made on the 99203. I made the proper adjustment, however, before I send the statement to the patient.  I would like to know if we have coded this correctly. 

Your response is very very much appreciated.  I thank you in advance.

D

Sriram_Sub

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Re: 99203-25 with 99385
« Reply #1 on: July 10, 2013, 09:03:36 AM »
I think it depends on whether you used different ICD codes on 99203 than the one you used on the preventive visit. If yes, you may call the Insurance and explain to try sending for reprocessing. Importantly, the ICD code on the office visit should represent an existing disease / problem of the patient and NOT just a preventive care reason like V70.0.

Regards
Sriram
Sriram

datwood

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Re: 99203-25 with 99385
« Reply #2 on: August 02, 2013, 05:55:40 PM »
Thank you very much for your help.

Dolores

Nadine

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Re: 99203-25 with 99385
« Reply #3 on: August 28, 2013, 10:00:15 AM »
I had one the other day. spoke with a rep and asked them to look at the hard copy of the claim and see that the diagnosis pointers where correct. The insurance had overlooked this. Got my claim paid in 1 week.