Author Topic: Help with billing out 67820  (Read 1010 times)

karric82

  • Newbie
  • *
  • Posts: 2
Help with billing out 67820
« on: October 12, 2016, 03:07:29 PM »
I am new to this so please excuse any errors I might do. I am having issues with getting Medicare to pay for 67820. I billed out separately for a E1 and E3. Denial was CO-151 Payment adjusted because this payer deems the information submitted does not support this many/ frequency of services. When it was billed out it was billed out separately. Line one was 67820 with modifier of E1 and line two was 67820 modifier of E3.   Thanks for your help.

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4706
    • Solutions Medical Billing
Re: Help with billing out 67820
« Reply #1 on: October 13, 2016, 07:56:09 AM »
What diagnosis code did you use?  Most likely it is saying that it doesn't support the service.  I was not able to find an LCD regarding it but I did find a coding website with information that may be helpful:  http://palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~JM%20Part%20B~Browse%20by%20Specialty~Optometry%20Ophthalmology~7R5KUQ4420?open&navmenu=Browse%5Eby%5ESpecialty%7C%7C%7C%7C

There was also a previous post about this CPT code.  The information there may help you.  Click on http://www.medicalbillinglive.com/members/index.php?topic=8114.0


I hope this helps.

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

karric82

  • Newbie
  • *
  • Posts: 2
Re: Help with billing out 67820
« Reply #2 on: October 13, 2016, 08:43:13 AM »
Diagnosis code H02.054  and H02.051 are what was used.

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4706
    • Solutions Medical Billing
Re: Help with billing out 67820
« Reply #3 on: October 14, 2016, 10:59:36 AM »
The dx codes appear to be ok.  I found the following which indicates that for Medicare the 67820 should be billed per eye, meaning use the 50 modifier if done bilaterally:

http://www.aao.org/practice-management/news-detail/billing-bilateral-epilation

Hope that article is helpful!

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