Smoking Cessation...Help!!!

mzshawnda2u

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I work for a Pulmonary Practice....Everytime I bill CPT 99406 (smoking cessation), they seem to get denied......Why is this??? Should I use a modifier, if so which one? Please help I am tired of having to appeal these:confused:
 

efrohna

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Are you billing these to Medicare (which State)? What diagnosis are you using? These are time based codes, is your time being documented?
 

mzshawnda2u

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Are you billing these to Medicare (which State)? What diagnosis are you using? These are time based codes, is your time being documented?
I am in Florida, Medicare will pay, sometime i have to sen in documentation...I know there agenda as far as how many attempts and sessions they will allow...But UHC and Tricare definitely will deny!!. I bill all visits a day after the patient is seen so its not a time issue. I did check a denial on a Tricare one today and its says the government will not allow Tricare to remit payment for that service. How is that possible when Medicare will allow it? UHC will say non-covered or not medically neccesary...Thank You all for responding!!!!
 

mzshawnda2u

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Are you billing these to Medicare (which State)? What diagnosis are you using? These are time based codes, is your time being documented?
I am sorry Efohna, I misinterpeted your question. I was thinking about timely filing...The times are not always documented as far as how many minutes were spent but the Dr's will put if they had an extensive session or not. That way I know which code to use:eek:
 
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