1. M

    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

    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

    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...
  4. L

    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

    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.