Modifer 59 usage - medicalbillinglive. com Should I add modifier 59 to 97112, 97116, and 97535 ( total of 3 times once for each CPT) or should I add modifier 59 to 97110 also ( making it a total of 4 times) once for each CPT except evaluation
EpiPen training - medicalbillinglive. com Well, since the children were not present I do not believe a nurse visit or E M is appropriate But there is a code, 97535 for training Not sure if it would be covered as it is considered a therapy code, and again, the children were not present Maybe bill with mom as patient? Anyone experience this?
97140, 97530. 59 MOD. NOT WORKIN HELP. - medicalbillinglive. com I bill for a PT practice who use 97140,97530 all the time I know 97530 needs a 59 modifier to unbundle the codes Every insurance pays, except for Oxford they bundle the codes It is on every claim Why are they the only one doing this? Are there any other codes that can be used to separate them Or any other CPT
Private Clinic O. T. CPT codes for parent conferences team meetings I had a client tell me that another OT clinic uses 4 separate codes for the hour because the reimbursement rate is higher- (e g 97530, 97110- therapeutic exercises, 97112- neuromuscular re-ed, 97535- self-care training)
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Discontinued Essure reimbursement Discontinued Essure reimbursement I am looking for a sample letter or advice to explain to an insurance company about a failed Essure procedure The device is ver'y expensive and I thought that I would try to bill it with a 53 modifier but what else can I do to recoup the cost of the device? The patients's tubes were not able to be seen so the procedure was discontinued Logged
Medi-Cal (CA Medicaid) Conversion Indicators Help me to understand what is going on with Medi-Cal I'm researching this cpt: 11042 (debridement), also please note I am using Modifier AG to denote primary surgical procedure Per the Medi-Cal fee schedule conversion indicators the allowable should be $37 23 However we seem to be getting reimbursed $83 77 (paying w RAD 0414 pymt reduced after review) My concern with this payment comes
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