I am unable to open any of the ppts on that website.

 

Please I'm constantly receiving rejections from Highmark Medicare Services,in ref to billing iv push and hydration below is an example  how my claim look,PLEEEAAAASSSSEEEE HELP ME.

99213

96360 59 X1

96361 59 X6

96374

J1200

96375 76 X2

J2550

96375 76 X2

J2270

85025

36415

WHAT IS WRONG???????

 

 

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ROCKY G

Rocky Jennings:

Please I'm constantly receiving rejections from Highmark Medicare Services,in ref to billing iv push and hydration below is an example  how my claim look,PLEEEAAAASSSSEEEE HELP ME.

99213

96360 59 X1

96361 59 X6

96374

J1200

96375 76 X2

J2550

96375 76 X2

J2270

85025

36415

WHAT IS WRONG???????

 

 

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ROCKY G

Hi Deborah, What website are you referring to where you cannot open the powerpoints?

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Christina Benjamin
Independent Coding & Education Consultant
Email: cmbenjamin@bellsouth.net
www.tools4coding.com

There could be a number of things wrong. Without having documentation regarding the start and stop times and the substances administered it is hard to tell exactly, but just looking at your codes, it could be the following possibilities: (1) that the hydration is considered integral to the therapeutic injection, (2) modifier 59 and 76 are not being applied correctly, For example, I don't see a need for modifier 59 or 76 to be appended on the codes you listed (3) I don't know how you are sequencing these codes, nor do I know if you are billing for the hospital or for the physician, but you must follow the sequencing guidelines prescribed by CPT. For example, if you are billing for the facility, the first listed code should be 96374, then 96375 with the appropriate number of units for listed only for a different (not 2 units listed for 2 injections of the same substance), then the hydration code 96361with the appropriate number of units based on the hours of hydration provided. These are just a few suggestions without the benefit of having further detail about the exact nature of the services provided and the setting for which you are billing for (facility or professional).

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Christina Benjamin
Independent Coding & Education Consultant
Email: cmbenjamin@bellsouth.net
www.tools4coding.com

Thanks for your response,this is facility(office setting).We give hydration and then we admin pain management 2-3 push each med.Please give me an example of how I should bil,please this is awful,my doctor is working hard.

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ROCKY G

Here is an example: If the patient comes in for 2 injections of 2 different pain killers, the codes assigned should be 96374 and 96375. Associated hydration should not be billed at all.

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Christina Benjamin
Independent Coding & Education Consultant
Email: cmbenjamin@bellsouth.net
www.tools4coding.com