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medi-cal

  1. M

    Wiki Inappropriate Modifier?

    Hello, we've been experiencing some denials from a specific insurance (medi-cal contracted) stating inappropriate modifier as the denial reason. What would be appropriate here? Thank you!
  2. R

    Wiki Medi-Cal Z7514

    How would you bill for observation (facility) that exceeds 24 hours? I have a claim that denied Z7514 x 2 as exceeding the benefit max. The description of the code reads, "room and board less than 24 hours". The patient was admitted to observation at 02:22 and discharged the following day at...
  3. W

    Wiki FQHC billing/services question

    Hello- I am writing from a clinic that is about to merge with a FQHC look alike. We will begin billing under the FQHC look alike's status and will receive the PPS rate for eligibile visits. Probably not necessary to say, but I have questions around what this looks like from a billing &...
  4. Y

    Wiki Medi-Cal

    I'm a bit stuck. I've starting working in billing with anesthesia. I recently got 3 Medi-cal denials for Family Pact, Z30.2 with 00851 or 00840, stating services cannot be paid with dx. Can anyone share on this please.
    • YRojas1986
    • Thread
    • anesthesia family pact medi-cal sterilization
    • Replies: 2
    • Forum: Anesthesia
  5. M

    Wiki Avastin for Medi-cal

    I am trying to Bill Medi- Cal for avastin. They are denying my 92134 and J9035 stating that codes are not payable with DX i am using. I am using E10.39 and E11.311, Does anyone know, how it should be billed? I dont have any problem getting paid with any other insurance, but Medi-Cal (of course)...
  6. T

    Wiki Billing California Medi-cal

    Hi, I am new to billing OB/GYN Medi-cal for California, and am finding there are so many rules and modifiers needed. I was wondering if anyone had some helpful resourses. Their web page is unhelpful. Especially information on 59400, 59510 and BTOs. Thanks, Tammy Hughes, CPC Practice Manager...
    • Tammy Hughes
    • Thread
    • 59400 billing california information medi-cal
    • Replies: 4
    • Forum: OB/GYN
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