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I have a patient with commercial insurance as primary, Medicaid as secondary. I'm not sure that their claims paid out properly.
We charged $185 for a service - the primary payer determined they owed $85, the patient owed $25 copay, and the contractual write-off was $75
We sent in a secondary...
I HAVE SUCH CONFUSION WITH AETNA AND A PATIENT WE HAVE. THE PATIENT IS 28 AND HAS 2 AETNA PLANS. ONE IS AN EMPLOYER PLAN AND ONE IS A STUDENT PLAN. WHICH ONE WOULD BE PRIMARY IF BOTH WERE ACTIVE AT THE SAME TIME, SAME MONTH?
I bill for a Clinical Psychologist who has opted out of Medicare. She has a new client hoping to see her who has 1. Medicare, 2. Aetna Retiree (self), and 3. Aetna Retiree (spouse). I am woefully underinformed when it comes to Medicare and was hoping someone who knows more about it could help me...
First off, I absolutely hate Medicaid with a passion (lol)
I'm located in Michigan and I received a denied claim Adjustment Reason Code 16: Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Do not use this code for claims attachment(s)/other...
I have a cardiology office visit case wherein the Problem List in the medical documentation states, among many other conditions, "Hypertension, hard to control secondary to left ventricular noncomliance and aortic inelasticity." However, later on, in the assessment, it is stated, "Blood...
If a patient has two insurances and the primary denies (denial is appealed and upheld), do you have to bill the secondary insurance? A co-worker was told to adjust and to not bill the secondary at all.
Do you use a "History of" code for a secondary cancer? For example, the patient is in for a 2017 followup visit. She was diagnosed in 2005 with breast cancer. In 2007 she had metastasis to her bones. Do you code Z08, Z85.3 or do you code Z08, Z85.3, Z85.830 (history of bone cancer)?
I...
I need help, keep getting secondary denials because of the g code used when billing medicare as primary. Secondary denies because of the g code but we must use that when billing medicare, tried billing secondary without the g code but then it denies because it doesn't match the primary amounts...
Can anyone tell me if there is any literature that tells what the default codes are for osteoarthritis (unspecified, primary, secondary)? I have heard default is primary, I have heard you have to go to unspecified. Can anyone provide me with any proof/literature to support their position?
i.e...
Can anyone tell me if there is any literature that tells what the default codes are for osteoarthritis (unspecified, primary, secondary)? I have heard default is primary, I have heard you have to go to unspecified. Can anyone provide me with any proof/literature to support their position?
i.e...
One of our providers is debating opting out of Medicare entirely. Many of her patients have secondary insurance in the for of supplemental and true "commercial" secondary. Though I've contacted many insurance companies, about this, none of my reps have responded with a definitive answer...
If...
How would we code secondary anemia due to Menorrhagia
Patient is having excessive bleeding with menstrual cycle and developed anemia. I think it should be coded N92.0 and D64.9. Can you please advise if this is correct way to code this? Thanks
We are Urgent Care and have an Ancillary contract with Cigna,UHC, and Aetna requiring us to bill S9083 at a flat rate regardless of what was done. I have a patient that is Medicare secondary. Cigna applied charges to pt deductible now I need to bill Medicare but they do not take the S codes...
I am having trouble finding the answer to this question. We have a patient who only has Medicare part A primary and Medicaid secondary. If part A doesn't apply to us, can we file Medicaid and expect payment? If so, would you file the claim as primary or secondary with the information of...
I had posted this on 1/11/2016 and got lots of views but no posts. Can someone help me? I think the secondary diagnosis should be R23.8 because the skin tags were being irritated by her clothing. Here is my previous post:Person had skin tags removed- CPT 11200. The diagnosis code used was L91.8...
Person had skin tags removed- CPT 11200. The diagnosis code used was L91.8 Skin tags, multiple acquired but secondary code was being required by insurance. Added secondary code L08.89 other specified local infection and insurance denied again. Can someone tell me what diagnoses should be used to...
ONCOLOGY CODING EXPERT NEEDED!!!
As an auditor for a physician group, I have been getting complaints about the coding of secondary cancer(s). I have reviewed a few of the other threads here, stating that if secondary site is coded, primary should be coded as well.
I used to teach coding & I...