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-   -   End stage Renal codes not covered (http://www.aapc.com/memberarea/forums/showthread.php?t=93392)

chrissy_klink@yahoo.com 06-06-2013 11:58 AM

End stage Renal codes not covered
I am receving denials for CPT 90960, 90961, and 90962 from all PA Medicaids stating that it is not a covered code. The patients are in an End-Stage Renal Disease Treatment Facility with a place of service 65. Is there another code I should be billing to receive payment for the provider seeing the patients?

mschelle1219 06-06-2013 01:28 PM

I'm not too familiar with PA medicaid but I deal with ESRD patients that are under our doctor's care in CA. 90960-90962 are the correct CPT codes when billing CA Medi-Cal (medicaid). It is billed from and through so you would bill a 90960 ex dos: 05/01/13-05/31/13. Check your medicaid billing guidelines on the proper way to bill for ESRD.

Hope this helped!

bethb 09-04-2014 01:56 PM

Hi. We are receiving the same denials as you are. Have you had any luck finding answers? We have not but we continue to reach out to different entities for help with the same issue you had.

Beth B.

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