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Medicare RTP reason W7009

Z

zimdano1025@sbcglobal.net

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Location
Wauwatosa, WI
Hi there. This is my first time using this platform, so I am hoping I am doing this correctly. I am having problems identifying the actual reason Medicare is returning claims being billed for FQHC with G0467 and 99397. Their representatives have given me different explanations depending on who you talk to. On the one hand, it appears we may need an additional line billed with a qualifying visit code but, no one can tell me if this is really the reason or not. The provider is enrolled and eligible in IMPACT (billing for IL). The revenue code being billed is correct (0521) and TOB is correct (771). Just looking for any feedback here. Thanks in advance.
 
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