Results 1 to 5 of 5

Suboxin Clinic

  1. #1
    Default Suboxin Clinic
    New Call-to-action
    Okay I'm having trouble getting 80307 to pay I spoke to Aetna Better Health and they told me the mod QW i have on there is wrong but said it does need a different modifier does anyone know what modifier would need to be used to get this paid? I've tried to research this extensively and I can't figure this out I'm pleading for help please!!!!!! This provider is based out of Kentucky. With a pos of 11
    Last edited by Kelsey07; 11-01-2018 at 09:13 AM. Reason: more info

  2. #2
    Default
    80307 is not a CLIA waived test. It must be a CLIA certified laboratory cannot be done under CLIA waiver. 80305 is the only code that is allowed under CLIA waiver.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  3. #3
    Default
    Okay so technically then it wouldn't need a modifier then? It's services rendered in an outpatient office setting pos is 11 so would it technically need a modifier?

  4. #4
    Default
    Or do you mean that 80307 doesn't need to be billed that 80305 needs to be billed?

  5. #5
    Default
    Medical Billing
    80307 if that is what was done then no QW as that is only for labs that are being done under CLIA waiver.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

Similar Threads

  1. Replies: 0
    Last Post: 10-01-2013, 06:22 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.