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Wiki Bundling question
- Thread starter adaniel
- Start date
RebeccaCross*
Guest
How old is the patient?
KMCFADYEN
Expert
Check with NC Medicaid on their policy. Some meicaid does not pay the administration code for tdap.
RebeccaCross*
Guest
Could this be your issue?
3. Append modifier EP to all immunization administration codes billed for Medicaid recipients in the Health Check age range, 0 through 20 years of age.
http://www.ncdhhs.gov/dma/bulletin/0611bulletin.htm
3. Append modifier EP to all immunization administration codes billed for Medicaid recipients in the Health Check age range, 0 through 20 years of age.
http://www.ncdhhs.gov/dma/bulletin/0611bulletin.htm
fdeffendoll
Contributor
the 90471 is bumping up against the 36415. I have had this issue and had to append a -59 on the 36415 to separate them out and got paid for all.
ckariel
Guest
well vst/sick vst
Is anyone having problems w/ visits not being paid if billed w/ administration codes (i.e. 90471, 90472, etc)? sick visit is billed w/ -25 modifier along w/ well visit.... the sick vst & admin codes may get paid but the well visit isn't....well vst may be bundled w/ admin?
Is anyone having problems w/ visits not being paid if billed w/ administration codes (i.e. 90471, 90472, etc)? sick visit is billed w/ -25 modifier along w/ well visit.... the sick vst & admin codes may get paid but the well visit isn't....well vst may be bundled w/ admin?