This just started oct 1, 2022 so i'm assuming new fiscal years Claims are being denied for lcd on an office visit with psychiatric dx codes, (these are not dementia or cognitive impairment codes) Is anyone else noticing aetna e/m claims being randomly downcoded without any justification We have had many 99214 downcoded to 99213, even though the mdm supported the 99214 If you are experiencing this and likely appealing, have you had any success in getting these decisions overturned? I access our anthem (our local bcbs) fee schedule in availity through claims & payments > fee scheduling listing > additional fee schedules and it's listed there
Alternatively, i can go to payer spaces > anthem ohio and fee schedule is one of the options under applications. Claim submitted like we usually do I would like to know how to properly report codes for 90471 for immunization Patient went to outpatient office because of chest pain It is then confirmed by the doctor that the chest pain is a contusion front wall of thorax Patient was given ibuprofen oral for the pain
Somewhere in this process the claims are not being routed to the correct payer id, 54704, and are instead going out with a header of isa08 So every single claim is being rejected as being sent to the wrong payer. On aug 19, 2022 axsome therapeutics announced the fda approval of auvelity, as the first and only oral nmda receptor antagonist for the treatment of major depressive disorder in adults I am so confused on what this arc means This was sent back to me by blue care network (part of bcbs of mi).i billed a tcm (99496) and medication reconciliation (1111f) The claim was processed without payment due the following
The related or qualifying claim/service was not. I am very confused why all of a sudden we are seeing denials using place of service 11 with modifier 95 and now they want us to use pos 10 for telehealth in patient's home and pos 02 if they are not home It seems to vary by payer and i know some are following medicare guidelines but we are. The automated system keeps repeating itself and asks us to check availity Unfortunately, availity is of not much help when it comes to claims being rejected without any reason code.
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