RTabacco
New
Hello Everyone -
I work for a small clinic that tries to provide medical care to the homeless and drug using population. We mostly run off grants but we (now that I am working there) are trying to bill insurances for our services as well.
I am fine billing basic E/M appointments. However, I am struggling with billing appointments for Sublocade injections.
An example is buprenorphine 300mg/1.5ml solution injection monthly to help someone control their substance use cravings.
I would bill 99213 for a 30 minute appointment with modifier 25. With that appointment I include G2069 "Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/ or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program)."
I received my first EOB back for billing this way. 99213 was approved and paid for. But G2069 was denied. When I called the insurance they said it was a non-covered code and they had no other advice or insight on what they would need.
Does anyone else's clinic provide this service and if so how have you been successful in billing for it.
Thank you for your assistance.
I work for a small clinic that tries to provide medical care to the homeless and drug using population. We mostly run off grants but we (now that I am working there) are trying to bill insurances for our services as well.
I am fine billing basic E/M appointments. However, I am struggling with billing appointments for Sublocade injections.
An example is buprenorphine 300mg/1.5ml solution injection monthly to help someone control their substance use cravings.
I would bill 99213 for a 30 minute appointment with modifier 25. With that appointment I include G2069 "Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/ or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled Opioid Treatment Program)."
I received my first EOB back for billing this way. 99213 was approved and paid for. But G2069 was denied. When I called the insurance they said it was a non-covered code and they had no other advice or insight on what they would need.
Does anyone else's clinic provide this service and if so how have you been successful in billing for it.
Thank you for your assistance.