Recent content by HWiggs3500

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    Wiki In house urine drug test

    I am in KY and recently Caresource has branched from Humana. I am confused for the laboratory coding they are asking. We do have a CLIA waiver. Can someone please help me with this? I have denials. My director is wanting to add QW on the codes. I know we have ran into many issues with this. Is...
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    I work in Mental Health field. Location is in Kentucky. Lets Chat!

    I work in Mental Health field. Location is in Kentucky. Lets Chat!
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    Wiki CMS NCCI Presumptive & Definitive Testing

    Has anyone seen any payments from reprocessing? As well as, getting paid for the Medicaids yet? My Medicaid payers are still denying for same thing. The NCCI Medicaid guidelines last I was told was to update theirs.
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    Wiki CMS NCCI Presumptive & Definitive Testing

    So doing the modifier 59 for the G-code is fine still?
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    Wiki CMS NCCI Presumptive & Definitive Testing

    My manager asked me if we should be billing modifier QW with the G-code, as well as, modifier 59. Our pos is 11 that fits our CLIA. Has anyone else billed the G-code with modifiers 59 and QW?? Please help!!!
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    Wiki CMS NCCI Presumptive & Definitive Testing

    Does anyone have support to Appeal some of the Medicaids that are still denying for the billing of 80307 and the G-code together? KY is my state.
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    Wiki CMS NCCI Presumptive & Definitive Testing

    I have seen Anthem KY Medicaid pay these correctly, as well as, Medicare. But Aetna Better Health and Passport Molina are still denying for the same reason.
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    Wiki Help with drug screens please!

    Has anyone ever billed the G-code without the presumptive 80307? Our lab can not perform the presumptive right now do to supplies and I am unsure if we can bill the G-code without the 80307?
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    Wiki 80307 & G0483 billing on same day with same DX

    Can we bill G0482, G0481 or G0480 WITHOUT the 80307? Currently, my laboratory has told me the cuvettes, which i am taking is the presumptive testing. Therefore, 80307 is not performed but they are wanting to send the urine out for definitive only without the presumptive testing.
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    Wiki CMS NCCI Presumptive & Definitive Testing

    Yes! We use Insync. We also sent test claims out and they are approved and being processed for payment.
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    Wiki CMS NCCI Presumptive & Definitive Testing

    We have sent out a few new test claims to keep track of and rebilled a few denied claims to keep track of. Hopefully we can see what happens. But I do think we are going to run into issues with the other payers for sure too. Because if you call they are still trying to say the same issue.
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    Wiki CMS NCCI Presumptive & Definitive Testing

    I know I haven't yet either. From my understanding they are to reprocess claims starting from 07/01/2023 that were denied. I am growing concerns as to if we will need to take the action instead. We sent a few test claims out and are seeing how they will go.
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    Wiki CMS Rescinds UDT NCCI Edits

    So, we are still good to bill for the 80307 and definitive G-code, right? All these denials have me lost at times or overthinking it.
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