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  1. M

    Verificaton on 2nd ins allowable less than 1st

    Can someone verify this for me. 1st insurance Medicare they pay then billed to United Behavioral Health who's allowable is less than Medicare so they do not pay at all. Can they do this? I always thought they would pick up difference because they are not the primary? Thank you in advance...
  2. M

    UBH as secondary Ins

    Hi, I was wondering if someone could help me answer this question, Here is an example: Pt has Medicare as primary, primary pays there allowable is $70.09 and then we bill the 2nd UBH the coinsurance due of $ 23.51, which UBH denied due to there contract rate is $65.00? I have not come...
  3. M

    Can you bill 90801 yearly?

    Can you bill this code yearly or must the dx be different in order to do this. Carrier is BCBS?
  4. M

    2 90801 with in same practice

    I was wondering if you can bill a 90801 for the same pt within the same group. This was within 2 months of each other. One provider is a CNS who handles the meds and the other is Psychologist who did another evaluation. My understanding is that the 90801 code be treated as a new pt thing and...
  5. M

    CANS Billing in MA

    Is there anyone who bills for CANS in the MA area I can talk to? The CANS billing is new to me and I have a few questions in regards to billing this. I appreciate any help with this. You can reach me at 866-321-4198 extension 102.
  6. M

    Billing for failed appointments

    Can we charge a pt our full fee for a failed appointment?
  7. M

    regarding billing under supervising Dr

    I have a situation where the provider has midlevel providers and they bill the insurance under the doctor as Supervising. Which the insurance allows. It is my understanding that the doctor must be present in the office in order for the midlevel to bill for the patients they are seeing. I...
  8. M

    assistc section for preclampsia

    I have not done ob coding in a while but someone asked me if the dx preclampsia is enough to use for a assist surgeon. When I coded for gen surgery we always used the exact same dx as the primary doctor. Any input would be helpful
  9. M

    90801 billing

    I have a situation where 2 different providers in the same group have billed a 90801 for the same pt on the same day. I asked about this and he stated the doctor did a Medical intake and the Psychologist did a Psychosocial intake. This does not sound correct to me but I am new to billing for...
  10. M

    dx code please

    does any now if there is a dx code for prophylactic measure for prevention of urinary infection. Thanks for all your help
  11. M

    billing Medicaid - I have a scenerio

    I have a scenerio where we billed Medicare a IUD placement and Supply in which they do not pay. The pt also has Medicaid and I sent the bill over to Medicaid with the Medicare eob and they are stating we are not authorized to bill. The claims rep could not help me at all. This situation is new...
  12. M

    Advice on taking CEMC exam

    I was wondering if anyone had any good advice for taking the CEMC exam? I am taking it on 12-5-09 and would love to hear any comments to do not to do. Thanks for any advice.
  13. M

    NP billing - under the supervising doctor

    If a NP is billing under the supervising doctor and sees an established pt to the practice but new to her can she bill that as a new visit? My thoughts are no since the pt is established already with the practice and this NP is billing under direct supervision of the Dr. Am I wrong or correct...
  14. M

    reference book for e/m

    I am taking the e/m speciaty exam in December and they allow 1 printed reference book of our choice. Does anyone have any good recommendations for this? Thanks
  15. M

    IUD Expulsion

    Does any one know the dx for IUD Expulsion. Other question is the IUD partially came out during procedure (colposcopy w/Biopsy) so the Dr finished taking out. Will this qualify for also billing a 58301 IUD Removal? Thanks
  16. M

    billing new pt versus est.

    Question, doctor has dual speciality, GYN , and Mental Health. Pt has been seen in the practice for Mental health but never GYN can we charge new pt for the gyn visit or would this still be an established pt because it is the same doctor? Thanks in advance.
  17. M


    Hi Everyone, I am wondering if you can help. I have a doctor who does not like to write a lot so on his gyn forms he has a section in which he just has a few words and we are wondering if that is would qualify as documentation for doing a bladder pressure study, Biofeedback. This is what it...
  18. M

    billing 90806 with 90862

    Can someone verify for me that I am correct.. or wrong. But I say you should not be billing the 90806 w/90862 it should be 90807. Thanks for the input. MonaLisa CPC:)
  19. M

    billing 96101

    How would you bill if 2.2 hours for this service? Our billing system will not show 2.2 Units but does reflect the money for 2.2 Units. I am reading the description for this and it states per hour so the doctor worked for 2.2 hours. So I am wondering if this should be billed as only 2 Units with...
  20. M

    Billing for Suboxone Induction

    I have a doctor who wants to start doing Suboxone Induction and I was wondering how this would be billed. These can take 1-3 hours in the office from my research and the doctor. I am thinking 90809 with more than 1 unit or prolonged services with the 90809 depending on the amount of time it...
  21. M

    90801 billed 2x within same group

    I have a group in which the pt seen the Psyhcologist which billed a 90801 on 2-20-09 and then she refers to Certified Nurse Specialist in the same group for Meds and the CNS now wants to bill a 90801 within a month. Can this be done. This does not sound right to me? But I may be wrong. Thanks...
  22. M

    ultra sound / sonohyst

    Hi Everyone. I am drawing a blank here. Billing out a 76830, 76831-58 w/ 58340 and I am getting denied on the 76830 as part of procedure. I know we have been paid before and they can be billed seperately but what did I do wrong? Thanks for any help