Wiki Denials when billing 99213 with a G0439

[franco@carolinafpc.com]

Hello, I continue to get denied when billing code G0439 with code 99213. I am attaching the modifier 25 with the OV 99213 but still denied. Any suggestionas as to what I am doing wrong? Thank You!

 

[laurenb922]

What insurance is denying? Or are multiple denying?

 

[franco@carolinafpc.com]

What insurance is denying? Or are multiple denying?

Humana Medicare

 

[CBLENNIE]

What is the denial reason you are specifically receiving when you bill G0439 & 99213-25 on the same DOS for your Humana Medicare patients?

 

[franco@carolinafpc.com]

The denial code is co-97 meaning the payer has already covered a service or procedure in another payment or allowance, and therefore, the provider is not eligible for separate payment for the same service. However, I am using sick codes (i10, I48.91, etc) for the OV and Z00.01 for the G0439, as well as adding the 25 modifier. Any suggestions would be appreciated. Thank you!

 

[franco@carolinafpc.com]

What is the denial reason you are specifically receiving when you bill G0439 & 99213-25 on the same DOS for your Humana Medicare patients?

The denial code is co-97 meaning the payer has already covered a service or procedure in another payment or allowance, and therefore, the provider is not eligible for separate payment for the same service. However, I am using sick codes (i10, I48.91, etc) for the OV and Z00.01 for the G0439, as well as adding the 25 modifier. Any suggestions would be appreciated. Thank you!

 

[franco@carolinafpc.com]

Humana Medicare

The denial code is co-97 meaning the payer has already covered a service or procedure in another payment or allowance, and therefore, the provider is not eligible for separate payment for the same service. However, I am using sick codes (i10, I48.91, etc) for the OV and Z00.01 for the G0439, as well as adding the 25 modifier. Any suggestions would be appreciated. Thank you! It took me this long to find the thread!