DFete105
New
I keep getting claims kicked back for marketplace claims stating "review CPT for Medicare billing" for patients with Marketplace insurances (like Caresource). Patients are not of medicare age, and clearinghouse will not accept preventive codes 9938X-9939X. These are obviously not IPPE/AWV visits, as patients are young and documentation does not meet.
What are you billing for these? Because when or if I change to E/M (99202-99215) they kick it back to me for the Z00 code (which is appropriate for the wellness visit). If it matters, we are an FQHC, I don't think this matters in terms of the CPT codes necessarily, it's just I'm getting a lot of these because of our status.
Thoughts on this?
What are you billing for these? Because when or if I change to E/M (99202-99215) they kick it back to me for the Z00 code (which is appropriate for the wellness visit). If it matters, we are an FQHC, I don't think this matters in terms of the CPT codes necessarily, it's just I'm getting a lot of these because of our status.
Thoughts on this?