Hello all:
Getting denials on ACP codes 99497 and 99498 from Managed Cares (Medicare Adv.) payers. Medicare guidelines have instructed to now enter modifier 25 on both the E&M and ACP which we have done but still getting denials. I have also reached out to another list serv. and they have instructed to use modifier 33 on ACP but since my visits are for inpatient, this modifier will not work. Another person stated that they use modifier 25 on E&M and mod 33 on ACP and still get denied. Has anyone else encountered these denials? Are there any way around getting the payments from these plans besides submitting Medical Records with each account?
Thanks,
Getting denials on ACP codes 99497 and 99498 from Managed Cares (Medicare Adv.) payers. Medicare guidelines have instructed to now enter modifier 25 on both the E&M and ACP which we have done but still getting denials. I have also reached out to another list serv. and they have instructed to use modifier 33 on ACP but since my visits are for inpatient, this modifier will not work. Another person stated that they use modifier 25 on E&M and mod 33 on ACP and still get denied. Has anyone else encountered these denials? Are there any way around getting the payments from these plans besides submitting Medical Records with each account?
Thanks,