Recent content by Revenuecycle

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    Wiki Virginia Medicaid Rates for BH

    Hello, Does anyone know where I can find information on Medicaid documentation requirements, billing codes, and reimbursement info for outpatient mental health services in the state of Virginia? Thank you in advance.
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    Wiki mental health med man services and telemed for medicare

    Claims We just started billing telehealth services. Does both the originating site and the distant site submit a claim when both sites are under the same TIN? Also, does the orginating site have to be certified as rural for the services to be billable?
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    Wiki BH services in an Article 28 clinic

    We have article 28 clinics that are specific to treating behavioral health conditions. We do not bill Incident To because we are under the impression that this can not be done in an Article 28 clinic- can someone verify this is correct? If I am correct in saying we are not able to bill...
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    Wiki Auditing suggestions or thoughts

    We are a hospital based clinic, Article 28 billing behavioral health services in NY. We are looking into doing internal audits on the charge capture, coding and billing of these services; does anyone have a process they would like to share or audit documents they would like to share that may be...
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    Wiki Ultrasound guidance/Biopsy

    We have a hospital owned clinic (billing and coding both the technical and professional component) that is looking for guidance on the following: 1. Diagnostic Ultrasound of Thyroid/Parathyroid – 76536 2. Ultrasound guidance for needle placement (biopsy, aspiration) – 76942 3. Biopsy of...
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    Wiki Article 28 clinic- Overseeing doctor Clarification

    We currently have a provider based clinic, Article 28 that provides behavioral health services. We are located in NY and there is some confusion on who should be billed out on the claim when it comes to Medicare. We do not bill with place of service 11, as this is hospital outpatient. The doctor...
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    Wiki Infusion billing - Article 28 clinic

    Hello, Can someone help me when it comes to billing Medicare/Medicaid (NY STATE) for infusion billing. I am looking for clarification on the following item: - In an article 28 clinic, is there a professional piece that can be billed by the clinic? So can we have both the TC component and the PC...
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    Wiki Swing Bed NYS Medicaid

    Can someone verify or point me in the right direction to get the following information....What revenue code should be applied to Swing Bed accounts for NYS Medicaid. Please and thank you.
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    Wiki ED to Obs

    I am looking for some clarification on place of service codes. If a patient comes to the ER and is seen and discharged by the ER Doc (professional charges)......what place of service goes on the ER CPT code? The same patient is then put in observation after being discharged from the ER...we...
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    Wiki NYS Medicaid

    Thank you so much!!
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    Wiki NYS Medicaid

    Can someone clarify if we can bill NYS Medicaid with a PA NPI if the overseeing ER doctor signs the note? We have conflicting answers here, some say we cannot bill Medicaid if the PA saw the patient and then some who say can bill the PA visit as long as the overseeing signs the note. Can...
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    Wiki frequency of 95165

    We are a provider based clinic in NY. NGS is denying our 95165 because they say the information doesn't support the frequency/units of this service. Does anyone know how to bill for this, what are the allowable units on this code. We are being paid on the 95117 but the 95165 is denying for the...
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    Wiki G0402/g0463

    Thomas, Thank you for all your help!! you are wonderful. So we are billing as hospital outpatient. The 1500 form is billing G0402 while the UB is billing G0463. My thought process is we should not be billing that G0402 on the same DOS that we are billing the G0463 with same dx code. The visit...
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    Wiki 95117/95165

    We are a provider based clinic in NY. NGS is denying our 95165 because they say the information doesn't support the frequency/units of this service. Does anyone know how to bill for this, what are the allowable units on this code. We are being paid on the 95117 but the 95165 is denying on the...
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    Wiki G0402/g0463

    I don't think I worded my initial thread properly- I guess I am wondering why we would be billing the TC at all? Wouldn't we just bill the IPPE for the professional side of things and I assumed everything was included in that one code.... Why would we bill that GO463, because as stated in the...
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