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First, Humana DID pay 80%. It's 80% of the allowed amount, not 80% of billed charges. $763.96 x 80% = $611.17.
But here's the thing... unless it is in the deductible period at the beginning of the ... [ Read More ]
Any advice would be appreciated.
I have an example of a patient that has Humana Medicare Replacement as primary and Medicaid as secondary. Billed amount $2,150. Humana allowed $763.96 and paid $611.17... [ Read More ]
[B]Procedures:
INCISION AND DRAINAGE OF ABSCESS WITH REMOVAL OF FOREIGN BODY[/B]: The plantar surface of the right foot was cleansed with Betadine swab sticks ×3. No local anesthesia was used. Th... [ Read More ]
Per NCD 20.15 its not covered for routine other than the initial welcome to medicare visit.
[QUOTE][COLOR=#000000][FONT="]There is no coverage for EKG services when rendered as a screening test o... [ Read More ]
[QUOTE="elizabethcaste, post: 426935, member: 344648"]How do you code a patient that is coming for therapy services and dx is status post rt shoulder arthroplasty?[/QUOTE]
Didn't see any replies, so ... [ Read More ]
[QUOTE="Chelsea1, post: 410292, member: 166144"]I do not know which stent code to use for the following portion of this report;
Using a LIMA guiding catheter, the ostium of the LIMA graft was cannuli... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
[QUOTE="kseverson, post: 402961, member: 40199"]I am a certified coder. In my current job, I'm an office manager and do the coding along with all the other office management tasks. I'm thinking abou... [ Read More ]
The Medicare Advantage organization says they are being held to unreasonable standards. Health Net of California Inc. was recently called out by the Office of Inspector General OIG for failing to subm... [ Read More ]
Reduce the clutter on your home page with one click. Codify offers a lot of tools on its home page but you dont always want all of them expanded at once. There is a simple way to maximize the tools yo... [ Read More ]
Strategies for unlocking a dialogue with physicians. As auditors we bridge the gap between medical coding accuracy and financial stability in healthcare organizations. Its our role to knock on the doo... [ Read More ]
Encourage patients to take stock of their relationship with alcohol. From Dry January and Dry July to Sober September and Sober October the monthlong abstinence trend of shunning alcohol has gained gr... [ Read More ]
Meet a member who never stops learning and growing. Each month AAPC selects a member who demonstrates exemplary leadership qualities. This month weve chosen Jennifer Lavoie RN CPC. Lavoie has enjoyed ... [ Read More ]