gwendolynmisevch
New
Hello all,
I have a physician who provides medical assessments for patients who have been admitted to a local psychiatric hospital. Frequently, there is no medical diagnosis, as the patient has no medical complaints or symptoms. In those circumstances, I am billing an inpatient initial evaluation (99221 - 99223 depending on complexity of history, etc) with a dx of Z02.89. Medicare has been denying our claims as non-covered because of the diagnosis.
I was hoping that someone here would be able to point me to a better diagnosis to represent the service that the physician is performing. Any thoughts? I truly feel that the Z02.89 is the "closest" option I had available to provide medical necessity.
I am aware that SNF codes should be used in this POS (per CMS guidelines) but the facility has informed me that all physicians rounding in their hospitals bill inpatient eval codes and requested that I do the same (I believe it has to do with how they are credentialed with NPPES).
Thanks for any help/thoughts/feedback. I appreciate it!
I have a physician who provides medical assessments for patients who have been admitted to a local psychiatric hospital. Frequently, there is no medical diagnosis, as the patient has no medical complaints or symptoms. In those circumstances, I am billing an inpatient initial evaluation (99221 - 99223 depending on complexity of history, etc) with a dx of Z02.89. Medicare has been denying our claims as non-covered because of the diagnosis.
I was hoping that someone here would be able to point me to a better diagnosis to represent the service that the physician is performing. Any thoughts? I truly feel that the Z02.89 is the "closest" option I had available to provide medical necessity.
I am aware that SNF codes should be used in this POS (per CMS guidelines) but the facility has informed me that all physicians rounding in their hospitals bill inpatient eval codes and requested that I do the same (I believe it has to do with how they are credentialed with NPPES).
Thanks for any help/thoughts/feedback. I appreciate it!