smontague
Networker
Hi -
I need assistance with this one as it does not seem appropriate to me, but not sure if others have had any issues.
The office where I code is an FQHC. We previously had BH carved out of this and so all our BH services were being billed as fee for service and all medical claims were going FQHC. Recently our FQHC scope was changed to include our BH services and when this was done it was back-dated to July 2012. Due to this we had to refund the fee for service payments and reprocess quite a few older claims for new payments.
So far we have not had any issues, however I have just run into an issue that I need some help with. Some of the claims were obviously past the one year filing limit and so when they were re-filed they were denied for being over the filing limit, however we were told they could be overwritten manually. I sent all necessary claim information on the denied claims to the appropriate person and now I am being told that I need to change the CPT codes to match the current manual. This would mean putting current (2013) BH codes on 2012 claims...this does not seem appropriate to me. The dates of service are all 2012 and when they were all originally submitted in 2012, the only reason for any resubmission is because they are now included in our FQHC services.
I would sincerely appreciate any advice.
Thank you!
I need assistance with this one as it does not seem appropriate to me, but not sure if others have had any issues.
The office where I code is an FQHC. We previously had BH carved out of this and so all our BH services were being billed as fee for service and all medical claims were going FQHC. Recently our FQHC scope was changed to include our BH services and when this was done it was back-dated to July 2012. Due to this we had to refund the fee for service payments and reprocess quite a few older claims for new payments.
So far we have not had any issues, however I have just run into an issue that I need some help with. Some of the claims were obviously past the one year filing limit and so when they were re-filed they were denied for being over the filing limit, however we were told they could be overwritten manually. I sent all necessary claim information on the denied claims to the appropriate person and now I am being told that I need to change the CPT codes to match the current manual. This would mean putting current (2013) BH codes on 2012 claims...this does not seem appropriate to me. The dates of service are all 2012 and when they were all originally submitted in 2012, the only reason for any resubmission is because they are now included in our FQHC services.
I would sincerely appreciate any advice.
Thank you!