Recent content by mfn1974

  1. M

    Wiki MA plans and alt level of care

    The order is for an inpatient stay, however the MA plan denies and states it qualifies for Obs... the letter doesn't state to rebill it that way, however the UM team is thinking that is enough justification to do so. In following Medicare guidelines, this practice is not acceptable (order is...
  2. M

    Wiki MA plans and alt level of care

    Running into semantics with the UM team related to alt level of care with MA plans.... I'm interested to know how others finalize a bill that has been denied due to nonqualification for an inpatient stay, particularly when the denial states the carrier considers it to be Obs. Do you rebill Obs...
  3. M

    Wiki Billing for new counselors

    Can someone provide insight as to whether billing can occur for the following counselors: Non-licensed (or not yet licensed) students of behavioral health programs, under supervision (may be used in times of access issues) Provisionally licensed or "interns" (those with a temp license undergoing...
  4. M

    Wiki Encounter Form with Codes for Opthalmology

    Looking for an encounter form for Ophthalmology - specifically Pediatrics. Need a list of codes to compile a proforma. Thanks to anyone with info!
  5. M

    Wiki Cpx & Immun With Mod 25

    Admin w/ CPE I agree with Lisa. It depends on your payer. We have seen the admin bundled in with the OV/CPE.
  6. M

    Wiki Tb Testing And Immunization Administration (cpt's 86580 And 90471)

    TB testing It is my understanding that the admin is included in it.:cool:
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