non covered

  1. A

    Question Workers Comp Non-covered Services

    I work for a group of Urologist. 51798 is not on the Workmans comp fee schedule and I cannot find an alternative code to cover service. Can we legally bill the patient for non-covered cpt codes/services ? Can you attach a link that explains rules for billing workmans comp and supports the...
  2. A

    Excluded services and discounts

    Looking for some guidance on this scenario: We bill $528.00 on a certain procedure code to every insurance company (commercial or Medicare). Based on our individual agreement with those insurances, we write off the difference to get down to our contracted amount (when it is a covered service)...
  3. B

    Not medically necessary

    I am really having trouble in determining as to why most of the insurance denies Autonomic Nerve system Test & heart rate (95923, 95943) for not being medically necessary while the DX I've billed does support the services billed. These codes being billed with a Diagnosis code G60.8. I tried...
  4. T

    Billing for Non Covered Services

    When billing for non covered services (hearing aids that are not a covered benefit) provided to a patient with a contracted insurance do I have to send a claim to the payor? Really it comes down to would the insurance have a contractual allowable for a non covered service? Yes, the patient...