Wiki Number of units billed

[pfilson]

Per an insurance carrier they are denying our claim for cpt code 99232 based on the number of units billed.

They state that effective January 1, 2016 per CMS we are not allowed to bill in multiple units. Each date of service must be a separate line item. We are looking for this ruling by CMS, but have been unable to locate it. Has anyone comes across this information?

Thanks,
Pam

 

[mhstrauss]

Per an insurance carrier they are denying our claim for cpt code 99232 based on the number of units billed.

They state that effective January 1, 2016 per CMS we are not allowed to bill in multiple units. Each date of service must be a separate line item. We are looking for this ruling by CMS, but have been unable to locate it. Has anyone comes across this information?

Thanks,
Pam

I haven't seen this info either. I haven't been made aware of any issues by our billing department. And I just checked a report of our 99232's since 1-1-16, and we have been paid by multiple payers, including Medicare, for claims that had multiple units of this code on one line.

Just to cover all bases...is there a "thru" date on the claim for this line with multiple units? That's the only typical problem I can think of that would cause that type of denial.

 

[CodingKing]

To tell you the truth I've never seen more than 1 DOS billed on a single line. Heck most of the time every single visit is showing up on a separate CMS-1500 form