Thursday, November 25, 2010

Copayment and timelimit for radiology billing

Cost Sharing (Copayment)

Copayment amount does not apply to services provided by Independent Radiology providers.

Time Limit for Filing Claims.

Medicaid requires all claims for Independent Radiology providers to be filed within one year of the date of service. Refer to Section 5.1.4, Filing Limits, for more information regarding timely filing limits and exceptions

Diagnosis Codes

For dates of service 01/01/99 and after, valid diagnosis codes are required.
The International Classification of Diseases - 9th Revision - Clinical
Modification (ICD-9-CM) manual lists Medicaid required diagnosis codes.

These manuals may be obtained by contacting the American Medical
Association, P. O. Box 10950, Chicago, IL 60610.

For dates of service prior to 01/01/99, Independent Radiology providers are
not required to provide valid diagnosis codes. Providers must bill diagnosis
code V729 on hard copy and electronically submitted claims.

NOTE
ICD-9 diagnosis codes must be listed to the highest number of digits
possible (3, 4, or 5 digits). Do not use decimal points in the diagnosis
code field.

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