General Category > New!
Medicare - CO151 - Payment adjusted because the payer deems the information
tperian:
That is entirely possible. How do we avoid this since the patient wouldn't know that is what the other physician charged? Do you suggest we recode the claim and refile it or would it be better to cut our loss?
Sriram_Sub:
If it is a scheduled appointment, you may verify benefits with the payer and see if your plan of Annual wellness care would be covered. By then, you would know if someone has already billed for that service during the same year.
tperian:
Thank you for your help. Since the HPI states that the patient was here for his annual wellness check, i would not be able to re-code this visit as an E&M. Correct?
Sriram_Sub:
For the current charge, you may change the CPT and ICD code if the chart notes (by any chance) has been documented with some diagnosis other than Z00.00 or so. This way, we may justify that the patient was given a consultation for a problem and that it was not a AWV.
For your future AWV charges, I would suggest to have their eligibility verified so that the reps can advise if the patient is eligible to get a AWV consultation given for the year. Hope this helps.
tperian:
It does. thank you so much for your help. Have a great day.
Navigation
[0] Message Index
[#] Next page
[*] Previous page
Go to full version