• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

told

  1. M

    Wiki Caresource (Medicaid product in OHIO) denying claim due to dx?

    Hi~ I have been told by one of our billers that he was told by a rep from Caresource that a particular claim has denied due to a diagnosis (but of course would not give him the exact 2dx in question). I have researched and could only find the following codes (that state needs additional code)...
  2. F

    Wiki Out Patient Hosptial Modifier

    Good Morning , Can you please let me know your thoughts on this. Should a TC modifier be applied to cpt 76000 on an outpatient hosptial billing. (actual facility charge) I have never heard of this, but am being told this has changed as of 01012016. I cannot find any information regarding...
  3. M

    Wiki Does new insurance mean new patient??

    I was told by a provider that when a patient obtains a new insurance, they are billed as a new patient (regardless of when they were last seen). The provider agrees that if someone hasn't been seen for three full years that they are a new patient. However, they have also been told that even if...
    • mfredericks73
    • Thread
    • billed insurance patient provider told
    • Replies: 3
    • Forum: E/M
  4. L

    Wiki OP coding question

    Hi, I had a test question that I was shocked that I did not get right. Scenario: Patient had lesion removed from arm, path report states cancerous. The answer they stated is correct is to code the cancer code and 709.9 ? Ok I have coded for a few hospitals and was always told never to do...
  5. M

    Wiki Interventional Procedures

    Our vascular physicians have been told that they can bill for attempted angioplasty/stent placement. We have received conflicting information as to whether we can bill for this or not and what modifier is appropriate...52 or 53? Anyone doing this?? Thanks.
Top