Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

PQRS codes on secondary claims

Marla Posted Wed 14th of January, 2015 15:54:19 PM

'If you submit G codes (PQRS codes) to the primary insurance, should the G codes be taken off of the claim going to the secondary insurance? we have gotten a few denials from secondary insurance carriers on claims with the G codes listed on them.'

SuperCoder Answered Wed 14th of January, 2015 22:50:44 PM

Thanks for your question. In many cases the secondary insurance will just disregard the PQRS codes when they receive it. They will usually deny the PQRS code as non-covered and process the primary procedure code. You can take the PQRS code off of the claim but you should not have to remove it in order to get your claim to process. If the secondary insurance company is denying the whole claim, then you may want to remove the codes prior to submitting the claim. Your clearinghouse should allow you to remove the codes before they are sent out. Hope this helps.

Related Topics