Hi, I have 8 years billing experience with HHA but this is my first time billing Internal Med, which I am finding out now is a whole different game. I am having issues with Medicare (doesn't everyone) paying on procedures performed in conjunction with E/M.
My first problem I just found out is that the Doc created their own superbills with proc codes they use the most often, problem is that it hasn't been updated. I know I have the wrong codes for Flu vaciness but not sure about the other problems listed below:
1. 93000 am attaching a mod -25 to the E/M but am getting denied due to needing a referring phys and/or ordering phys. The Doc is the primary and doesn't require one (as far as I am aware). Is that the current code for an EKG? and Do I need to add the mod -59 to the 93000?
2. 90658 Seasonal flu inj and 90472 Seasonal flu/Admin. From what I found yesterday 90658 is no longer valid and I must use Q2035-Q2039 with G0008 for the Admin, is that right? Does it matter which one we use, or are those specific to brands? Will I also need mod -59 or any others?
3. Holter Monitor 93224, Doppler arterial 93922, and Bone Density 77080, Mod -59? Are those even the correct up to date codes?
4. Prostate or Yearly women exams? Can I bill WITH E/M? Modifiers?
SO SORRY for all the questions! I am figuring out most of it, but there seems to be a few issues I can't seem to find answers on and would like to get these resolved before they get too much older!
Thank you everyone for the help, it is much appreciated!
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My first problem I just found out is that the Doc created their own superbills with proc codes they use the most often, problem is that it hasn't been updated. I know I have the wrong codes for Flu vaciness but not sure about the other problems listed below:
1. 93000 am attaching a mod -25 to the E/M but am getting denied due to needing a referring phys and/or ordering phys. The Doc is the primary and doesn't require one (as far as I am aware). Is that the current code for an EKG? and Do I need to add the mod -59 to the 93000?
2. 90658 Seasonal flu inj and 90472 Seasonal flu/Admin. From what I found yesterday 90658 is no longer valid and I must use Q2035-Q2039 with G0008 for the Admin, is that right? Does it matter which one we use, or are those specific to brands? Will I also need mod -59 or any others?
3. Holter Monitor 93224, Doppler arterial 93922, and Bone Density 77080, Mod -59? Are those even the correct up to date codes?
4. Prostate or Yearly women exams? Can I bill WITH E/M? Modifiers?
SO SORRY for all the questions! I am figuring out most of it, but there seems to be a few issues I can't seem to find answers on and would like to get these resolved before they get too much older!
Thank you everyone for the help, it is much appreciated!