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Wiki Not billing due to non coverage

dpitcher6

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I have a gut feeling that I am doing something wrong by doing this, and I cannot find anything that is really matching up to back myself up. I have always been told by other coders to just trust your gut, because most of the time, its right.

I work for an FQHC, and we have a lot of patients that are under the care of CCM. Medicaid does not pay for CCM. We bill Medicaid for only 20 minutes (99490) no matter how much time has been met. We have been instructed to delete any other charges for CCM (99439 ea additional 20 min) due to them not covering that code. We bill any other insurance that covers CCM that additional time code.

Can someone please give me a link to guidelines, or tell me where to find the information to end this and confirm to me that this is okay to do? They would see this as making the write off amount rise, but in my eyes, if that is what needs to happen, then so be it.

Thank you for any help that is given!
 
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