Wiki 80101qw

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nyyankees

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i was told that we couldn't use this code anymore. Now I'm told we can use for ALL insurance companies BUT medicare. Which is it and is there any written proof of it that I can bring to my Dr's? Thanks.
 
nyyankees said:
i was told that we couldn't use this code anymore. Now I'm told we can use for ALL insurance companies BUT medicare. Which is it and is there any written proof of it that I can bring to my Dr's? Thanks.
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The above statement is correct. There is a new code to use for Medicare. I am not currently at work but it was effective 4-1-10. Have you checked your carriers website...

Hopefully I'll have a few minutes tomorrow to email it to you.

If you give me your email, I'll send it to ya.
 
nyyankees said:
Are you still using the 80101QW for the other insurance companies with multiple units? I think that's what my Dr's want to know. Thanks again.
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Yes, but we dont' use the QW modifier for other insurance companies only Medicare.
 
Our office has also recently started billing for the drug sreening. We are billing 12 units but Medicare does not allow 12 units on one line. We are having difficulty getting the second line paid. What is the appropriate way to be billing this to get reimbursement. Any help would be wonderful. We have contacted Medicare and have been told multiple things buy multiple people.
 
G code

saprice said:
Our office has also recently started billing for the drug sreening. We are billing 12 units but Medicare does not allow 12 units on one line. We are having difficulty getting the second line paid. What is the appropriate way to be billing this to get reimbursement. Any help would be wonderful. We have contacted Medicare and have been told multiple things buy multiple people.
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Have you tried a redetermination form w/ Medicare? The office I work for has never had an issue billing this to Medicare- you are using the new G code effective for 4-1-10? We have only ever billed 5 or 8 units so I am not sure about the 12 but if thats how many drug classes your doc is testing then that should not be an issue.

Do you have a contact at Medicare? In the past when I've had an issue with Medicare I actually wrote to the Medical Director and he sent me a letter back as well. You could go that route if all else fails.

Good luck!
 
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