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    Wiki Billing Questions Highmark Speech Therapy Claims Denials

    So this is more billing related rather than coding related... But I am at a loss and figured it would not hurt to ask. I work for large FQHC as a Coding and Billing specialist. We bill for Speech and Occupational Therapy.. These kid's are seen multiple times a week and usually exhaust their...
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    Wiki New Patient to group but Est. To provider under different tax ID?

    looking for some clarification on this.. as information given by one of our Behavioral health insurances is conflicting. we recently hired a new provider to our group who practiced with another group in the area Same specialty but Different Group NPI and Tax ID This provider will be bringing a...
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    Wiki New RSV vaccines?

    Has anyone had any luck with any insurances adding the new RSV vaccines to their fee schedules yet? I keep checking fee schedules for our major payers but no one has added them yet with a fee... also been trying to stay on top of newsletters and articles but just haven't found anything yet...
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    Wiki Denials for 96372 & same day E/M MULTIPLE CONDITIONS.

    I am having a huge issue with Highmark only paying on the 96372 and B12 injections and denying the E/M even with modifier 25 when there are other conditions being addressed. An example i have a patient who comes in to see the provider for multiple conditions but also due for their B12 injection...
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    Wiki 96110 Developmental Screening Code Requirements

    I have been researching this endlessly with no clear answer.. We use the SWYC as our tool for developmental screening and have a tool build into Epic. If a Patient is seen for a Well Child check and the developmental portion (milestones and POSI) was all that was completed because there were no...
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    Wiki Provider Education/Training advice needed!

    Hi everyone! I am really hoping to get some guidance on this topic. I worked for a large FQHC I recently became certified in April just accepted the official coding specialist position last week.. a position that has not been filled for over 2 years.. I have worked at the office level to...
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