Recent content by Ebernhardt

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    Wiki Unlisted CPT - CAH Method II Billing

    Does anyone have any tips for getting unlisted procedure codes paid in the CAH - Method II billing setting where professional fees are billed on a UB04? Our contractor is denying saying they cannot accept unlisted codes on a UB04. We are specifically struggling with 37799 - vein therapy, 28899...
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    Wiki Medicare Denials - Infusion Coding Guidelines

    As far as I know, we are still billing per DOS instead of per encounter, against coding guidelines.
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    Wiki 96127 and Medicare G0438, G0439

    Prior to 2020, there was a CCI edit for billing 96127 (brief emotional/behavior assessment) and G0438, G0439 (Medicare Annual Wellness Visits) but we have noticed the edit does not exist for 2020. Does anyone know if there was a change and we are allowed to bill these codes together now? Thanks!
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    Wiki G0500 Moderate Sedation Billing - Medicare Claims

    Hello, Does anyone have experience billing G0500 as a Method II CAH provider? We currently bill G0500 on the UB with all other facility and profee charges and our claims have been getting RTPd by Medicare. Any suggestions or required rev codes, modifiers, etc.? Thanks in advance! (This has...
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    Wiki CAH Moderate Sedationg Billing - G0500

    Hello, Does anyone have experience billing G0500 as a Method II CAH provider? We currently bill G0500 on the UB with all other facility and profee charges and our claims have been getting RTPd by Medicare. Any suggestions or required rev codes, modifiers, etc.? Thanks in advance!
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    Wiki 99477 - Newborn Transfer of Care

    Hello, Is it appropriate to charge 99477 when a baby is born, admitted, and transferred to a different facility on the same day? We are a CAH and deliver many babies but do not have a NICU, so we sometimes have to transfer newborns to a facility with a higher level of care. The provider does...
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    Wiki Medicare Denials - Infusion Coding Guidelines

    Recently, Medicare has denied some infusion, injection, and hydration charges on our observation claims due to not having an initial service billed for each date of service on the claim. Our HIM Dept is stumped because we have always followed the coding guidelines that only 1 initial service...
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