Mperkes72
Contributor
Hi everyone,
I am seeing a lot of these holds for injections. Can someone help me out with this. I see this on Prolia, allergy , Vit B too. So it just puts it on a hold and I need to process these claims. Putting CS modifier on the claim doesn't do much either. These are nurse visits so the provider hasn't seen the pt.
" Per payor guidelines, incident-to or ancillary service are reimbursed as part of the all-inclusive encounter rate and should not be billed as stand-alone services. Currently, there is no encounter code present on the claim to indicate that there was a face-to-face encounter. Please review the coding on the Claim Edit screen to determine if there was an actual face-to-face encounter.
Thank you for you help
I am seeing a lot of these holds for injections. Can someone help me out with this. I see this on Prolia, allergy , Vit B too. So it just puts it on a hold and I need to process these claims. Putting CS modifier on the claim doesn't do much either. These are nurse visits so the provider hasn't seen the pt.
" Per payor guidelines, incident-to or ancillary service are reimbursed as part of the all-inclusive encounter rate and should not be billed as stand-alone services. Currently, there is no encounter code present on the claim to indicate that there was a face-to-face encounter. Please review the coding on the Claim Edit screen to determine if there was an actual face-to-face encounter.
Thank you for you help