Search results

  1. C

    Question Allscripts

    We have Allscripts PM and EHR, what specific reports are you trying to generate?
  2. C

    Question Vaping Code

    Look at F17.290 Nicotine dependence, other tobacco product, uncomplicated. There is not one specific code that states vaping, but the description of this one states other tobacco product.
  3. C

    Billing for a contracted provider

    When billing for contracted services, you will need to add your location and TIN to the provider insurance companies . We done this for an LCSW until we located a permanent solution. You need to attach all your information to the provider NPI and you need to attach the provider NPI to your...
  4. C

    Can RN perform treatment of cryotherapy after physician sees pt and writes order?

    Does anyone have the physician see the patient and determine the need for cryotherapy for wart removal and the RN perform the treatment have any billing issues? I cannot locate any documentation stating only the provider must perform the service. Could you still bill for the service under...
  5. C

    FQHC Injections

    Have you tried adding a modifier to the E/M? :cool:
  6. C

    FQHC Biller needs help!

    Tcm The TCM has the face to face component inside the code, so I would not bill an additional E/M level. I think you will find the following websites helpful with the TCM...
  7. C

    FQHC Billing G0101

    M15 CO97 billed service or benefit is not separately payable by the health plan. Sounds like this service is not deemed high risk for the patient or has been billed more than once in a two year period. therefore not payable and that reflects the M80 Not covered when performed during the same...
  8. C

    FQHC Billing G0101

    No, For FQHCs billing under the PPS, G0101 and Q0091 are qualifying visits when billed with FQHC payment HCPCS codes G0466 or G0467. 3rd paragraph last sentence in the MM8927. So you would bill the two codes for the service and the visit codes at the same time. Since you were getting a CO97...
  9. C

    facility fee at FQHC?

    The split out to Medicare Part B services go on a HCFA 1500. Yes to the rendering provider NPI. Carla
  10. C

    FQHC Billing G0101

    G0101 Medicare Requirements G0101 is reimbursed by Medicare every two years, unless the patient is considered high risk. I have attached the MLN Matters for these services in a FQHC setting...
  11. C

    facility fee at FQHC?

    Laura, X-ray, EKG, PFT are split billed per Medicare Guidelines in FQHC world. If a patient comes into your office for a visit and you perform a chest x-ray the technical part of the x-ray is billed to the local Part B and the professional part is rolled into the G code for the FQHC visit...
  12. C

    Billing Two Visits From Same Date to Medicare (FQHC)

    FQHC PPS rates Robert, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-PPS-FAQs.pdf https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/FQHC-PPS-Specific-Payment-Codes.pdf. The above should help with your dilemma. From FAQ...
  13. C

    Medicare Contract 855R

    Yes Yes you can hold those claims, but Medicare may not retro the start date on the date you saw your first patient. You can file the claims according to Medicare Timely Filing which is 365 days from the date of service. Hope this helps.:cool: Carla Townsend, CPC, CPPM, CPB, CH-CBS FQHC...
  14. C

    FQHC Billing

    https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/fqhcfactsheet.pdf Have you checked out this document from CMS? Hope it helps Carla :cool:
  15. C

    Correct coding/billing of a CDL physical

    I do know that you have to upload the CDL physical into the FMC site. I don't know what state you are in but the below link may help. https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/Copy%20of%209-18-15%20State-by-State%20Instructions%20for%20Submitting%20Med%20Certificate_1.xlsx Hope...
  16. C

    BCBS - Why won't they pay?

    90461 and BC/BS 90461 is an add on code for the vaccines. For example, a patient gets the Rotavirus vaccine and the DTaP-HIB-IPV vaccine. The Rotavirus vaccine is a single component. The DTaP-HIG-IPV is a combination vaccine. It has five components. You would file the claim with 90460 x two...
  17. C

    Can an fqhc facility bill for 90853?

    Per the Medicare Benefit Policy Manual Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services 170 - Mental Health Visits (Rev. 220, Issued: 01-15-16, Effective: 02-01-16, Implementation: 02-01-16) A mental health visit is a medically-necessary face-to-face...
  18. C

    Wiki Billing Delivery

    I found the following that may help: ICD-10-CM Coding Rules •O80 is applicable to maternity patients aged 12 - 55 years inclusive. •O80 is applicable to female patients. •O80 should be used on the maternal record - not on the newborn record. •Use a code under Z3A to document the exact week...
  19. C

    FQHC MCR Billing - Behavioral Health Providers

    Joyce, Sorry I normally do not keep this page open everyday and did not see your additional post. I have never worked with psychiatrist. I would think that the psychiatric codes in the CPT book would be better suited then a 99213. I did go to cms.gov and pull the following pdf that may help...
  20. C

    FQHC MCR Billing - Behavioral Health Providers

    You are correct on both points. It really messes with the A/R, but it also gets written off as a contractual adjustment so it works itself out just over inflates the charges and adjustments. Medicare required that we list both of them on the UB-04 but the only pay line is the G code. It was a...
  21. C

    FQHC MCR Billing - Behavioral Health Providers

    FQHC Behavioral Health Providers Joyce, In our FQHC we bill the services of LCSW under the facility . G0469 – FQHC visit, mental health, new patient and G0470 – FQHC visit, mental health, established patient. The following is an excerpt from the Specific Payment Codes for the Federally...
  22. C

    Child Biting other children

    Biting Children JodyLynn: Could you possible use V61.20 Concern about behavior of child. It is normally a counseling code for parent-child problems, it is unspecified.
  23. C

    99211 With Medical Assistant

    Cindy, This article can be read at web site http://www.aafp.org/fpm/20040600/32unde.html#5 it is from the American Academy of Physicians. This may help. The article is entitled Understanding when to use 99211. The presence of a physician is not always required. Although physicians can report...
Top