Listserv Lately 10
by Suzan Hvizdash, CPC, CRN Senior Auditor, Instructor
I don’t know if the eastern part of the US is starting to freeze, but it’s been a relatively quite two weeks on the list serve. Productive, just quite!
One thread involved the Prompt Payment Laws. Do insurance companies have to provide their guidelines? Do all payers follow these laws? The question was about how long the insurance company can take to pay a claim, request additional documentation, respond to an appeal, etc. The poster was trying to appeal a -59 modifier denial and wasn’t getting very far with the insurance company in getting a response. The poster now wants to send an appeal letter quoting the Prompt Pay Laws and wanted the lists opinion. Great idea!! Why not ask that many experts all at once?
Can a provider bill for a Guiac test in addition to the Welcome to Medicare visit? For Medicare the codes G0107 and G0328 can be billed in addition to the base visit. The 82270 code with the V76.41 has been getting paid by another poster. The consensus on the list was this service is billable and reimbursable.
What about billing for 99211 and requiring a countersignature. The PMCC text indicates that these services when billed “incident to” need to be countersigned. The poster was questioning this. It appeared when looking at the responses; it appears to be more of a state licensing regulation instead of a billing requirement. It is suggested that your state licensing board be reviewed to determine the exact supervision and signature requirements.
Let’s not leave this article without talking about this weeks live chat. Remember these are scheduled for every other Tuesday at 2pm eastern standard time. They are great way to meet some of your friends from the list as well as talk about what you’re working on at that moment.
Until next time,
Joining the list serve: $0
Asking questions on the list serve: $0
Advice received on the list serve: Priceless
Reading your bi-weekly CRN newsletter: $0
The value of reading your bi-weekly CRN newsletter: Priceless
Suzan