Ashley Posted Fri 09th of October, 2015 12:02:09 PM
Medicare and other payers are denying the this code when I use more than one of the add on codes above code denial states" Payment adjusted because payer deems the information submitted does not support this many/frequency of services. examples 37228,37232,37232-76
am I billing this incorrectly or do I just need to appeal they with medical records. I could not find anything showing that you can only bill on add on code. thanks
SuperCoder Answered Mon 12th of October, 2015 07:11:44 AM
Well, it should not be denied. May be there is wrong claim filling. The correct pattern to code the scenario is- 37228,37232x2 without modifier 76. There is no need to put modifier with add on code. Now, you can re-frame or re-bill it. Otherwise appeal it with proper documentation. Hope it helps!
Ashley Posted Tue 13th of October, 2015 08:03:51 AM
So are you saying bill it in units instead of line by line?
SuperCoder Answered Wed 14th of October, 2015 04:24:35 AM
Well, it depends on the claim form you are filling. You can fill it both ways (units or line wise), depending on the pattern of claim form you follow, but with proper documentation. Hope it helps!
Ashley Posted Wed 14th of October, 2015 09:30:29 AM
we are a doctor office pos 11 and we bill on a hcfa 1500
SuperCoder Answered Thu 15th of October, 2015 04:35:26 AM
Ok. You can fill it both ways. But, it advisable to fill line wise for batter clarification or to avoid the missing of units at the claim office.