Timely filing and authorization missing denial – complete overview

TFL denial reasons codes and action plan CO – 29 – The time limit for filing has expired. Amerigroup/BCBS of WNY: Timely filing 120 days from the DOS. Contact Provider Relations to discuss timely filing denials. HealthFirst: Children’s timely filing claim...

CPT 0059U, 0060U, 0062U -Oncology Merkel Cell Carcinoma

CPT Code and Description 0059U – Oncology (Merkel Cell Carcinoma), Detection Of Antibodies To The Merkel Cell PolyomaVirus Capsid Protein (Vp1), Serum, Reported As Positive Or Negative. 0060U – Twin Zygosity, Genomic-Targeted Sequence Analysis Of...

CPT Code 64490, 64491, 64492, 64493

CPT Code and Description 64490 (cervical or thoracic) or 64493 (lumbar or sacral) reports a single level injection performed with image guidance (fluoroscopy or CT). Procedures performed under ultrasound guidance are not covered. 64491 or 64494 describes a second...

What Are Services Covered By Medicaid?

Covered Services: a. Except for specific laboratory tests identified under non-covered services, the Division of Health Care Financing and Policy (DHCFP) reimburses organ or disease oriented panels, therapeutic drug assays, evocative/suppression testing, clinical...

CPT 29824, 29827, 29828 – Arthroscopic Rotator Cuff Repair

CPT Code and Descripiton ▪ 29824 – Arthroscopic claviculectomy including distal articular surface ▪ 29827 – Arthroscopic rotator cuff repair ▪ 29828 – Biceps tenodesis Coding and Billing Guidelines. Description of Special Study: The CERT review contractor conducted a...

CPT 93880, 93882, 93886, 93888

Cerebrovascular Arterial Studies (93880-93893)  93880 Duplex scan of extracranial arteries; complete bilateral study 93882 Duplex scan of extracranial arteries; unilateral or limited study (To report common carotid intima-media thickness (IMT) study for evaluation...

COLONOSCOPY BILLING CODES– CPT 45380, 45385

Colonoscopy Billing Tips – CPT 45380, 45385 As a speaker at many national conferences, I find the question most frequently asked is, “What is the proper way to code a screening colonoscopy?” First, let’s talk about what is a screening colonoscopy. Physicians suggest a...

Employer Group Waiver Plan – Overview And FAQ

Employer Group waiver plan Employer Group Waiver Plans (EGWPs) are well-positioned solutions to help you keep costs down and offer valuable retiree benefits. An EGWP has financial benefits that significantly exceed current RDS payments. You should consider an EGWP if...

CPT Code 47562, 47563, 47564 – Laparoscopy, Surgical, Cholecystectomy

CPT Code Description 47562 Laparoscopy, surgical; cholecystectomy – Average fee amount – $600 – $750 47563 – Laparoscopy, surgical; cholecystectomy with cholangiography 47564 – Laparoscopy, surgical; cholecystectomy with exploration of common duct – Average fee amount...