Medical Billing Forum
Billing => Billing => : TXBiller April 16, 2019, 10:48:20 AM
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I need assistance in figuring out what the below is telling me. Any help you can give will be greatly appreciated.
222: Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific. NOTE: Refer to the 835 Healthcare Policy Identification Segment (Loop 2110 Service Payment Information REF), if present.
N640: Exceeds number/frequency approved/allowed within time period.
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What kind of CPT are you getting this denial for?
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What kind of CPT are you getting this denial for?
Yes, need more information to be able to help.
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Sorry about that.
99203 with mod 25 received both CO-222 remark N640
G0444 CO-222 remark N640
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The answer is sort of right there in the denial codes. The services being billed have exceeded the amount allowed in a give time frame.
The provider has already billed a new patient E/M on this particular patient within the last 3 years, so cannot bill another one, and the provider or another provider has already billed a depression screening for this patient in the last 12 months. Medicare only allows one depression screening every 12 months for a patient.
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