Wiki CPO Help

[mrsjehu]

I am new to billing Care Plan Oversight and I am having a bit of difficulty. Do these get billed to Medicare even if a patient has a Medicare advantage plan? We have a patient with Humana that I billed out using the 99374 and 99375 codes and they were denied. I received this denial "Procedure code billed is not correct/valid for the services billed or the date of service billed" Or am I supposed to be billing the G codes, I thought those only went to Medicare not Medicare advantage. I have a whole stack of these that I need to get billed out and I am having troubles. Any help would be greatly appreciated!

 

[kbarron]

I believe that most of the Advantage plans follow all of MCR rules. I would definitely use the G codes.

 

[mrsjehu]

UPDATE: I billed the Medicare Advantage plan for my test patient, and we received payment. So thank you kbarron, that was the trick!