Question 99072

shanamarie

Networker
Messages
64
Location
Eagan
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0
Has anyone billed and been paid for this code with their office visits?
I think it’s to soon to know. Since the code just came out last week we have not found any payors that have this updated in their systems yet. We have billed for this, but all claims have been rejected from the clearing house stating it’s invalid, so we are currently working on that.
 
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6
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0
We have started billing this code but the clearing house is kicking it back. I will keep you posted once we are successful.
Any suggestions on documentation requirements for this code?
 
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2
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0
I think it’s to soon to know. Since the code just came out last week we have not found any payors that have this updated in their systems yet. We have billed for this, but all claims have been rejected from the clearing house stating it’s invalid, so we are currently working on that.
I have about 38 pages of claims rejected due to this code. What are you guys doing with the claims being rejected? I called a few insurance companies and they do not have any information as to when this code will be added in to their system. I am thinking about submitting paper claims since it wont cross over electronically. Thoughts?
 
Messages
355
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0
Payers that choose to reimburse code 99072 may also provide automatic reprocessing of the denied claims but it would be good now to look into how you can track and, as needed, rebill those claims with denial of the service. I found one reimbursement policy indicating that Medica will not pay for the code and considers it bundled to other services provided. This was included in the policy for COVID-19 Testing so be aware that the reimbursement policy may not easily found for some payers.

Cindy
 

SharonCollachi

True Blue
Messages
1,199
Location
Clovis, CA
Best answers
3
Payers that choose to reimburse code 99072 may also provide automatic reprocessing of the denied claims but it would be good now to look into how you can track and, as needed, rebill those claims with denial of the service. I found one reimbursement policy indicating that Medica will not pay for the code and considers it bundled to other services provided. This was included in the policy for COVID-19 Testing so be aware that the reimbursement policy may not easily found for some payers.

Cindy
THIS. Payers are not required to pay for this.
 

CatchTheWind

True Blue
Messages
649
Location
Boca Raton, FL
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0
According to DermCoder, "BCBS has recently stated they will not be reimbursing for this code." (They do not state which BCBS they are referring to, so I am guessing Florida, since that's where DermCoder is located.)

DermCoder also says that you can use this code with E/M or procedures, and that you can use any diagnosis.
 

mccoyheather

Contributor
Messages
19
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0
Read this article: https://www.aapc.com/blog/51794-ama-approves-2-new-cpt-codes-for-covid-19/
cite link from article: Transmittal 10373, CMS Pub 100-04 Medicare Claims Processing Transmittal 10373: States new AMA codes released 9/8/2020 will be:
"EFFECTIVE DATE: October 1, 2020 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: October 5, 2020" hope this helps. Our office has denied claims for 99072, applicable to any face to face encounter during PHE from 03/01/2020 to 12/31/2020 thus far. We are holding claims until 10/5. Good luck!
 
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1
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0
Has anyone figured out why this code keeps getting kicked back from the clearinghouse or should I just bill this code on paper? All of my medicare claims have rejected due to HCPCS, but I can't find anything on this code.
 

mgortega23

Contributor
Messages
14
Location
Plainview, TX
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0
Has anyone figured out why this code keeps getting kicked back from the clearinghouse or should I just bill this code on paper? All of my medicare claims have rejected due to HCPCS, but I can't find anything on this code.
I have been told by some insurance companies that it is taking 60 days from when it came out. I had to remove all claims as my clearinghouse kicked them all out. I'm waiting 60 days to bill.
 

cford0204

New
Messages
1
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0
So far the only payer to reimburse us is Aetna; They paid $6.00. BCBS and Humana have held each claim for further review. Medicare straight up denies the code at the clearinghouse.
 

sarab86

Guru
Messages
115
Location
Fort Myers, FL
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0
According to DermCoder, "BCBS has recently stated they will not be reimbursing for this code." (They do not state which BCBS they are referring to, so I am guessing Florida, since that's where DermCoder is located.)

DermCoder also says that you can use this code with E/M or procedures, and that you can use any diagnosis.
We are getting reimbursed from Fl Blue.
 

sarab86

Guru
Messages
115
Location
Fort Myers, FL
Best answers
0
Has anyone figured out why this code keeps getting kicked back from the clearinghouse or should I just bill this code on paper? All of my medicare claims have rejected due to HCPCS, but I can't find anything on this code.
Our Clearinghouse is rejecting all Medicare Part B claims with this code. They called Medicare and we did and because CMS has not made a decision they will not accept the code. Which I think is crazy because CMS has issued a transmittal that it is a recognized code for OPPS however its a non-facility service. Never make any sense with CMS.
 
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