Medical Billing Forum
Billing => Billing => : Adnare01 July 13, 2018, 12:51:01 PM
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Billing Question!
We keep getting denials on the claims from Medicare Michigan which are billed with CPT code 99358 (Prolonged E&M service) with denial reason as PR-172 (Payment is adjusted when performed/billed by a provider of this specialty). Provider is a Ph.D (Clinical Psychologist). I have no clue to get them paid. Any help would be highly appreciated.
Best Regards,
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Is that code within the scope of practice for your provider? If so, you need to appeal using the guidelines set out by your MAC.