Wiki GA medicaid and 99051

[cighade]

Can anyone help me with billing 99051 please? Medicaid says I didn't bill it the proper way and I am not sure what the proper way is. I did include the office visit code 99213 as well as an ICD 9 code. Please help, thanks!


Cynthia

 

[hewitt]

Can you post the exact wording of the denial/denial reason?

 

[cighade]

Thanks, the exact denial messages are:

2 4871 PROCEDURE CODE NOT COVERED FOR CLAIM TYPE
2 4801 THESE SERVICES CANNOT BE BILLED ON THIS CLAIM FORM OR THE PROVIDER TYPE LISTED FOR THIS PROVIDER NUMBER CANNOT FILE THIS TYPE OF CLAIM

 

[GoLeun22]

Check the providers contract. All of my conversation with GA Medicaid states that 99051 is not a billable/payable code per contract.

However, they are paid by the CMO's on occasion when we bill with a modifier 25 on sick visit or well visit (if no sick visit).

Hope that helps!