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Patient copay apply on 99024 FX followup??

  1. #1
    Location
    Fayetteville,NC
    Posts
    23
    Question Patient copay apply on 99024 FX followup??
    Medical Coding Books
    Good morning all,


    Quick question- should our office staff be collecting copays from patients' whom have been billed thru insurance or self pay for FX treatment and return for FX followup care (99024) during 90 day gliobal? I said no copay should be taken from patient-in dispute w/billing manager-need some quick advise/explanation if possible.


    Thanks in advance!

  2. #2
    Location
    Augusta, Ga
    Posts
    11
    Default copay for 99024
    No. We do not collect copays for 90 f/u they are included in the fx charge.

  3. #3
    Location
    Fayetteville,NC
    Posts
    23
    Default
    Thank you for your repy & time -I know this is out of the "coding" scope but I also felt we should not be collecting copays on followup 90 day global FX care visits-

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    There is no associated fee with 99024. The definition of a global package (CPT and CMS) is very clear on what services are included in the global package. Collecting a copay for a service related to the surgery, during the global period, is not appropriate. Your billing manager should become more familiar with coding guidelines and carrier contracts.

    Addendum...

    It's possible that if the provider is re-applying a cast (example only), the carrier may apply a copay to this service. This would become carrier/policy specific. If the only service provided is a standard, global period, office visit, no copay.
    Last edited by RebeccaWoodward*; 05-12-2011 at 10:14 AM.

  5. #5
    Default
    I often find that Aetna, Cigna, and United Healthcare plans will have situations where if you do a cast application or an x-ray they apply a copay to those charges. Our patients get pretty upset with this so we have had to tell the front desk to change the wording when they tell a patient that normally they don't have a copay for a post op visit but that some payors are applying a copay if other services are performed. I always refer them back to the insurance to check their benefits. On another note we are trying to find a way when we are calling to verify benefits and eligiblity to check to see if the plan will apply copays as in the above situation but the customer service reps don't understand either what we are asking or how to check. Does anybody have any tips in this situation?

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