Wiki 90791

[Pkirsch1]

Hello,
90791 denied for using twice in 365 days, but it was billed by 2 different Providers/NPI's.

Is it because it's billed under the same facility? Would the dx matter?

Thank you.

 

[ckeeney]

Usually the rules are payer specific. I know Medicare and our state Medicaid have slightly different frequency guidelines. We even get some denials if there is a 90791 done by a different facility within the allowed time frequency.