Wiki Commercial Ins Home Health Coding

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Cymerick

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Does anyone out there have Home Health billing for commercial payer experience? I have many questions and am having next to no luck getting answers. Several payers want billing done with CPT codes, others want HCPCS codes. An info/suggestions are welcome.
 
Commercial Home Health Codes

Does anyone out there have Home Health billing experiance for commercial payers. I am getting denials with no answers and many questions. Several payers want billing done with CPT codes, others want HCPCS codes. An info/suggestions are welcome. :)
 
This will vary by payer...

Most contracts for Home Health services are written to specifiy the use of HCPCS codes.
However, this is going to vary by payer and by what type of services you are billing.
If these are home infusion services, you will have HCPCS codes for the drugs and supplies and CPT code(s) for the nursing visits (if any.) You need to get together your EOBS and organize them by payer, and ask each about their denial codes and ask for clarification about why your claims are being denied.
 
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