Benefit Maximum

nishaganesh

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Frazier Park, CA
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Hey there, I have a billing question regarding one of our Medicare Advantage PPO patient through Anthem. We billed G0444 along with an office visit and this cpt was denied with
CO119 : Benefit maximum for this time period or occurrence has been reached. N381 : Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges. My question is can we bill the patient. If not, why? The patient has reached the cap and this is not our fault.
 
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