99201
Hello, and thank you for answering many of my past questions! And...here's one more... I work for a family practice in So Cal. We have been receiving denials from Medicare for new patient visits 99201...
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Since it is Medicare, it would be helpful if you listed ALL of the denial codes and their explanations from your eob. List all of the M codes as well as any PR or CO codes.Sharon
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What were these patients seen for during their first visit. A 99201 is the lowest code for a visit. Normally very little was performed and the medical condition was of very low complexity.
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Maybe the patient would have just showed up his head to enroll into the hospital/medical practice as a new patient and therefore they are billing 99201. The carrier would have thought it medicall not...
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Well, we can play "what if" until the cows come home, but it won't get us any closer to an answer. We need to know what was denied and why, and what else was done, as well as the diagnosis codes.Sharon
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The male patient was seen for the first time in our office for urinary incontinence - 788.32 . The denial code was CO-B18 - procedure code / modifier invalid - for 99201.Thanks! Diane
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Well, that is a start. Did you bill for anything else at all? What were the OTHER codes on the EOB? What M-codes were on the EOB?Sharon
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That's the start and the finish... The only M code for this patient is the standard MA01 - "If you do not agree with what we approved for these services..."
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I have some questions:The patient is a senior citizen that has no control over their bladder and this is the patient's first visit.How long has this been going on? Is the patient taking any meds for...
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If all they had was a simple visit (although that pretty much seems impossible for what was probably done), and you used a valid diagnosis code, AND this is a new patient to your group, AND your...
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Thanks for the response. This was the patient's first visit to our office. The doctor sent him to the local hospital with orders for his lab work - so the office visit was our only charge. Our doctor...
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Diane,Please don't take this the wrong way, but based on what we have been told, in my personal opinion, your doctor is not even performing proper medicine. What we have been told is that here we have...
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I think this has taken a wrong turn here... The doctor has done nothing but undercharge as he circled the 99201 on the charge ticket - after spending plenty of time with the patient going over his...
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The turns that are taken are based on what info is given to us.Now that you mention that a hx was obtained, tests were ordered and meds prescribed, we now know more than we did before.This is not a...
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Well, we've yakked about this for 5 days now. As I stated before, maybe you should just CALL MEDICARE. I don't know who your carrier is, but I hardly ever have to wait to talk to a claims person at my...
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