Medical Billing Forum

Billing => Billing => : TXBiller March 03, 2019, 12:39:38 PM

: 36415
: TXBiller March 03, 2019, 12:39:38 PM

I have billed Medicare for 36415.  When I do, I get the following.  Can someone help me understand what they are telling me please?

CO-16:  Claim/service lacks information which is needed for adjudication.  Additional information is supplied using remittance advice remarks codes whenever appropriate.
N211:  Alert:  you may not appear this decision.
N264:  Missing/incomplete/invalid ordering provider name.
N284:  Missing/incomplete/invalid referring provider taxonomy
N285:  Missing/incomplete/invalid referring provider name
N754:  Missing/incomplete/invalid referring provider or other source qualifier on the 1500 claim form.

thank you in advance

: Re: 36415
: Michele March 05, 2019, 09:52:26 AM

When you bill for a 36415 the ordering/referring provider must be on the claim.  It may be the same as the servicing provider, but it still must be listed as the ordering/referring provider.  For example, patient comes in to see Dr Jones and Dr Jones decides to draw blood.  Dr Jones is the rendering provider AND the ordering/referring provider.

: Re: 36415
: TXBiller March 17, 2019, 02:34:43 PM

Thank you