Non Covered Denials

The No. 1 claim error for June in 11 states plus the District of Columbia was for non-covered charges, according to Novitas Solutions, Medicare Administrative Contractor for Jurisdictions H (Arizona, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas) and L (Washington DC, Delaware, Maryland, New Jersey, and Pennsylvania). This error is identified by Explanation of…

CPT G0447 & CPT G0442 (2021)

CPT G0447 & CPT G0442 (2021)

Coding Guidelines  for Screening  and counseling  servicesMedicare:Medicare does not allow the billing of other services performed on the same day as an obesity counseling CPT CODE visit. Screening Services Codes:CPT G0101, CPT G0102, CPT Q0091, CPT G0442, CPT G0444 Reimbursement Guidelines:The comprehensive nature of a preventive medicine code reflects an age and gender appropriate examination. When a “Screening…

Denial reason CO-22 or PR-22 & CO-19 – Tips to correct these denials

Denial reason CO-22 or PR-22 & CO-19 – Tips to correct these denials

Claim Adjustment Reason Codes (CARC) CO-22 Denial Code or PR-22 Denial Code This care may be covered by another payer per coordination of benefits. CO-19 This is a work-related injury/illness and thus the liability of the Worker’s Compensation Carrier. You may also receive a Remittance Advice Remark Codes (RARC) N127 This is a misdirected claim/service…

Denial Reason CO-50 Non-covered services – Tips to correct this denial

Denial Reason CO-50 Non-covered services – Tips to correct this denial

Claim Adjustment Reason Codes (CARC) CO-50  Denial Code. These are non covered services denial because this is not deemed a ‘medical necessity’ by the payer. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. In addition to Claim Adjustment Reason Code you may receive Remittance Advice Remark Codes…

What is Condition code G0 (zero) ?

What is Condition code G0 (zero) ?

Usage of Condition code G0 in the Hospital Outpatient Prospective Payment System (OPPS) indicates that the visits were distinct and independent of each other and, therefore, qualify for separate reimbursement for each visit. Modifier 27 would be appended to the appropriate level of E/M codes. The condition code G0 must appear in form locator 24-30 on Hospital…