• 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 Marketplace Preventive Exam Help!

Create Wiki
D

DFete105

New
Messages
5
Location
Lithia, FL
Best answers
0
I keep getting claims kicked back for marketplace claims stating "review CPT for Medicare billing" for patients with Marketplace insurances (like Caresource). Patients are not of medicare age, and clearinghouse will not accept preventive codes 9938X-9939X. These are obviously not IPPE/AWV visits, as patients are young and documentation does not meet.

What are you billing for these? Because when or if I change to E/M (99202-99215) they kick it back to me for the Z00 code (which is appropriate for the wellness visit). If it matters, we are an FQHC, I don't think this matters in terms of the CPT codes necessarily, it's just I'm getting a lot of these because of our status.

Thoughts on this?
 
You must log in or register to reply here.
Top