I have a patient that has been giving me grief since the day she was seen regarding what codes she wants us to bill for a visit regarding a contraception discussion with our physician. I billed the claim to what we did on the date of service. The patient has a $35.00 copay and wrote a lengthy letter (after telling me that I don't know how to bill) stating that her visit should've been covered at 100%. I tried to call her insurance to figure out what code to bill it with but it seems that I'm just going to have to send them the notes to let us know what we did wrong. I billed the claim with V25.04, we also could've billed it as V25.40. Neither of those DX were inaccurate but she wants us to bill a certain one for it to get paid at 100%. I can't find any sites that just spell out what codes to use and this woman is rude and disrespectful. Please help me.
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Wiki Please HELP!!!
- Thread starter kenkie79
- Start date
mitchellde
True Blue
If this is not specified as to natural or prescriptive or if it included all forms then I would use the V25.09. The only way this could get paid at 100% is if was a preventive physical, but it does not sound like that is what happened here. The patient is more than welcome to notify the payer that she feels this is billed in error but note will show different.
Squiabro
Networker
Please Help!
EM codes 99401-99404 with ICD9 CM V25.09 will pay at 100% with most major carriers. Most likely she is aware of this and is arguing that point.
Hope this helps!
Rose Squiabro, CPC, CPMA, CEMC
EM codes 99401-99404 with ICD9 CM V25.09 will pay at 100% with most major carriers. Most likely she is aware of this and is arguing that point.
Hope this helps!
Rose Squiabro, CPC, CPMA, CEMC
mitchellde
True Blue
I do not feel that contraceptive management and preventive counseling are the same thing. I guess it truely depends on the note.