medicaid

  1. N

    Wiki IL medicare xover claims

    Recently our office has experienced claims NOT crossing over from IL Medicare to IL Medicaid. Has anybody else been seeing this happening?
  2. P

    Wiki Medicaid FFS - Nevada - 51/59 modifiers

    I bill for an OB and am trying to bill 58552 with 57282. These two codes do allow a modifier. Medicaid keeps denying for incorrect modifier. We tried 51 and 59 on the 57282. Any thoughts or is anyone else having this issue with NV Medicaid?
  3. C

    Wiki Is the Q0 modifier required for OP Medicaid Patient getting an AICD?

    I am curious if the Q0(zero) modifier is required to be added to CPT 33249 for patient undergoing a OP procedure for implantation of an Automatic Implantable Cardiac Defibrillator primary prevention. I know thi sis required for Medicare. I am unsure is this applies to Medicaid. Any help would...
  4. L

    Wiki NC Medicaid help please?

    We have an ENT dr that does procedures in our facility (ASC), we are having an issue when he does a T&A (42820) or Tympanostomy (69436) along with any 30802,30930, or 30140... We get paid by commercial carriers however NC Medicaid doesnt pay but for the primary procedure. I am thinking this is...
  5. T

    Wiki Medicaid-Patient's primary

    Patient's primary insurance paid for 99242 consultation except $25 copay. Patient's secondary ins Medicaid denied cpt 99242 as non covered by plan. Can we bill the patient for the $25 or do we have to adjust it off?
  6. M

    Wiki Medicaid denials per announcement 976

    We are having a problem with Medicaid denying secondary claims per CMS announcement 976 stating that "history of ..." diagnosis codes are not acceptable as primary diagnosis codes. In these cases Medicare has paid the claim with a hx code but Medicaid is denying. I am not sure how to fix them -...
  7. H

    Wiki Will Medicaid pay if Medicare denies in NC?

    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...
  8. I

    Wiki GC Modifier- we are getting denials

    Hello, we are getting denials from Medicaid when billing codes 99215, 99213 and 99214 with modifier GC when the services were provided by a resident under the supervision of a teaching physician. We are sending the claims with the teaching physician Medicaid NPI number. When we called Medicaid...
  9. J

    Wiki No fault won't pay driver was drinking

    OK I have a patient that was driving drunk when they were injured in a motor vehicle accident. Under NYS no fault, their insurance company is not required to pay. I billed them anyway and course they denied payment. This patient has straight Medicaid, will Medicaid pay for these office...
  10. D

    Wiki 99420-HD Illinois Medicaid

    We are receiving denials from Illinois Medicaid for postpartum depression screen. We have instruction from Illinois Medicaid to report 99420 with HD modifier under the child's RIN. Since ICD-10 we are receiving denials and find no code for postpartum depression screen. Previously we were able to...
    • drashby
    • Thread
    • depression illinois medicaid receiving screen
    • Replies: 0
    • Forum: Pediatrics
  11. J

    Wiki 64493 dx coding for Medicaid MI UHC

    Medicaid MI UHC, Having trouble getting these paid for MMB, they keep saying dx issue, can anybody please help if you are getting these pd is Michigan ????
  12. S

    Wiki Billing Psychotherapy and Evaluation to Medicaid

    Hello, Medicaid plans are not paying psych codes such as 90871. I was told that these plans will only pay H codes. (eg H2019). Has anyone else ran into this issue? Unfortunately I cannot find much reading material on billing these codes. Thanks in advance for any advise you may have.
  13. S

    Wiki 80301 and 80302 bundled?

    Has anyone seen any information on these codes being bundled? We are billing to some of our Medicaid plans and 80302 pays but 80301 denies stating CCI incidental to or part of primary procedure, CMS medicaid NCCI unbundling? Just looking for any insight into this. Thank you. We use an...
    • skweston
    • Thread
    • 80301 80302 bundled cms medicaid
    • Replies: 1
    • Forum: Anesthesia
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