Wiki Clinical Daily Maximum Exceeded?? 99070

[sjrebeck]

Due to contractual limitations, we are having to bill some of our drugs under 99070 instead of the generic HCPC's code since the generic HCPC is not recognized by our contract. However, when billing for multiple drugs, only one drug is being paid as the remaining lines containing 99070 are being denied for "clinical daily maximum exceeded." Does anyone know of a way to bill 99070 multiple times in a single day? I have researched some MUE's to see if there are answers there, but so far nothing. Let me know. Thanks!

 

[halebill]

I certainly hope you can get the contractual issue resolved soon. 99070 is a code of last resort. Every insurance carrier may handle this differently. Are you also submitting the drug name, NDC # and units in the supplemental information on the claim. If you are submitting all of the necessary information, minus the correct code, the only option left may be appeal. Good luck!