Wiki Billing

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Minotrn57

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Hello, I work for a practitioner who does complex chronic care management which is billed as a 99487 in her practice. Her practice is comprised of patients in skilled nursing facilities, etc. Additionally she will do her face to face encounters which she will bill as a 99348 or 99350 etc.. Recently we billed a 99487 and the insurance company did not pay because they are saying it is a bundled service. does anyone have any guidance as to why it is saying it's a bundled service?

Thank You
 
Interesting. Per CMS, Chronic care management is priced in both facility and non-facility settings and per NCCI it's not bundled. But if you're dealing with a commercial payer, they may have their own policies.
 
Its a providence dual eligible medicare advantage HMO, OK thank you for your feed back. I really appreciate it.
 
Can someone provide guidance about how to submit a claim for telehealth done for a Assisted living Facility/Residential facility. We use codes 99347-99350 for an established patient. From what I gather Medicare does not use GT modifier anymore and prefers the telehealth POS 2 or 10. So are these residential facilities considered POS 10? Additionally, modifier 95 can't be used for CPT codes that are not in appendix P which 99347-99350 are not. Any guidance is greatly appreciated.
Thank You
 
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