ahelige
New
We are a health department who has a family planning program in Illinois.
I am the biller and I use a basic general billing sheet where I very often bill something like:
S4993 Birth Control
99401 / Z30.09 with an FP Modifier
99212 OR 99214 OR 99213 / Z30.40 with a 25 Modifier
My 99214 / 99213 never gets paid - they always just pay the 99401 which is billed at a significantly lesser amount.
I do not have any formal coding training so its difficult for me to try and figure out on my own; but I feel like we need to be using more specific Z codes in regards to the 99212/99213/99214 if the patient had an PAP, or Breast Exam for example. Also, I do not understand why I never use codes for Preventative visits (99394/99395/99396) because they are on my sheet but never used.
I am sure that when we started this program years and years ago this was the proper way to bill for these services. However I cannot find any current information regarding Family Planning program billing in Illinois and honestly I am not sure there is any.
Any help would be so greatly appreciated!! Thanks so much in advance
I am the biller and I use a basic general billing sheet where I very often bill something like:
S4993 Birth Control
99401 / Z30.09 with an FP Modifier
99212 OR 99214 OR 99213 / Z30.40 with a 25 Modifier
My 99214 / 99213 never gets paid - they always just pay the 99401 which is billed at a significantly lesser amount.
I do not have any formal coding training so its difficult for me to try and figure out on my own; but I feel like we need to be using more specific Z codes in regards to the 99212/99213/99214 if the patient had an PAP, or Breast Exam for example. Also, I do not understand why I never use codes for Preventative visits (99394/99395/99396) because they are on my sheet but never used.
I am sure that when we started this program years and years ago this was the proper way to bill for these services. However I cannot find any current information regarding Family Planning program billing in Illinois and honestly I am not sure there is any.
Any help would be so greatly appreciated!! Thanks so much in advance