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96372 - Medicare (Georgia) keeps rejecting

  1. #11
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    Medical Coding Books
    Yes there is,,,and no matter how many times I have told this practice they insist on using it..specifically for PT INR.. when this is only reason for the visit, I cannot justify 99211 when I ask for the note they do not have one..then a few days later...provider sends me a note stating this charge is correct....we have a few pt who bring in their own med, nurse documents vitals, states nl and give shot... So I go by what the provider says.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  2. #12
    Location
    Columbia, MO
    Posts
    12,531
    Default
    You should go by documentation. It is wrong to use the 99211. I disagree with doing just what the provider says when I know it is wrong, I would change the code and face the consequences.

    Debra A. Mitchell, MSPH, CPC-H

  3. #13
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    I did a couple years ago...I was removed from my coding position. In Sept..the whole upper management was relieved of their positions...new manager put me back to coding...came very close to giving it up..I am still rusty,,,2 yrs out of coding and there were alot of changes...however the provider is still doing the same thing he did 2 1/2 yrs ago...I have been researching to be better able to state my point.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  4. #14
    Location
    Columbia, MO
    Posts
    12,531
    Default
    There was a decision health article in 2002 Feb 11, written by Kathleen Mueller who was the compliance officer for CMS, She issued a warning about using the 99211 for blood draws and injections and cited a solo practitioner and his office manager that were fined heavily for using the 99211 for this purpose when they were aware that it was incorrect. Their rationale was that it was being paid. I hope you can get this resolved as it is a huge issue.

    Debra A. Mitchell, MSPH, CPC-H

  5. #15
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    I will look for that article....I have been googleing @ work..but never seem to be able to spend much time research...I want to thank you for all your help..you have enlightend me on quite a few things today. Thanks for your time!...Off to play BINGO!.We will talk again...my work email is kbarron@hugginshospital.org Thank you again.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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