Wiki Nephrology Office Billing Code 90966

[kguzikowski]

Billing for Patient's home Dialysis charges each month. What is the appropriate date of service to bill for this charges always the first date of each month-Example 3-1-20, or the date of the comprehensive visit by the physician? Example 3-15-20?
Conflicting answers on this question seems UHC denies if we send with the first date of the month, and they turn around and request Medical Records, they deny because Medical records do not match documentation.
Date of service to bill for 90966?

 

[kathleeng]

It depends on the carrier. It's typically billed for the first day of the month. From my recent experience, Medicare carriers tend to prefer billing the last day of the month, Medi-cal wants through dates 1st-last day of month, and all other carriers want the first date of the month. 90966 is for treatment of the entire month so it's not typically billed for the date of service of the visit w/ the MD.

 

[kguzikowski]

Would you also bill services rendered at the Dialysis Centers 99060, 99061, 99062, as the first day of the month or the first day the patient is seen in that month?

 

[kathleeng]

Same rules will apply. I have worked for two nephrologist offices in the last 6 years and both billed it the same.

 

[kguzikowski]

Thank You