Wiki Medicare and code - I am having difficulty

adflatham

Guest
Messages
4
Best answers
0
I am having difficulty in getting claims paid by Medicare (Cahaba GBA for TN) when we do urine drug screens at an office visit. We are PM&R and do pain management. We use the code G0434 QW modifier for clia waived and was told to put the Clia # in block 23 of the HCFA 1500 as this might help claim to be paid. This still isn't working. Still being denied with CO-16. I did however have two claims paid in the past week, while 9 were denied with the CO-16, all filed at the same time, and there is no difference in these claims or the way they were coded. Dx pointer is to V58.69. All patient info is correct as well. Anyone else have this problem or can tell me what I am doing wrong?
:confused:
 
I bill to Cahaba as well, and it sounds like you are doing everything correctly. Do you have multiple offices? If so, you need a CLIA number for each. Make sure the correct one goes out with each claim. Barring that, you need to call Medicare and find out if they are not receiving the number at all, or whether they are receiving the incorrect number. Good luck.
 
Top