• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Coding Phone consultations

Create Wiki
lopezk89

lopezk89

Networker
Messages
59
Location
Minnetonka, MN
Best answers
0
I have been billing them and having the PT fill out a release for saying that this is not a covered benefit and they the will be charged this fee. I need to know if I append a modifier .
 
lopezk89 said:
I have been billing them and having the PT fill out a release for saying that this is not a covered benefit and they the will be charged this fee. I need to know if I append a modifier .
Click to expand...

Careful to make sure your documentation meets the criteria for the CPT code - If the patient is told to come in and see the doctor within the next 24 hours, or the next available urgent care visit appointment, or if the call is related to a previous E/M reported within the past 7 days, it's not billable at all. Billing a patient for a service in those circumstances would be a violation of your contracts - it's as good as unbundling and balance billing the patient for the incidental work.

That said, if you're billing Medicare, you have to have a real ABN signed, and you'd use the appropriate HCPCS modifier, either GA, or GX if they refused to sign.

Commercial will not require a modifier, but expect to have medical records requested for the encounter. Hope that helps!;)

Cute pic, by the way...:D
 
You must log in or register to reply here.
Top