Guest guest Posted March 29, 2010 Report Share Posted March 29, 2010 I just billed a company with EM code 99214 and acup 97810 but forgot to put a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I resubmit the 92114 on a seperate claim to get paid for that part of the visit? Or is it not possible since i already billed it incorrectly? thanks for your input! , LAc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2010 Report Share Posted March 29, 2010 Since they've already processed that claim, you can't rebill. (Regardless of whether they've processed the claim, you can't submit a claim twice for the same visit anyway.) Your only option at this point is to follow their appeals process, whatever that may be. Or forget about it and chalk it up to a learning experience. On Mon, Mar 29, 2010 at 2:22 PM, wrote: > I just billed a company with EM code 99214 and acup 97810 but forgot to put > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > resubmit the 92114 on a seperate claim to get paid for that part of the > visit? Or is it not possible since i already billed it incorrectly? > > thanks for your input! , LAc > > > > > --- > > Subscribe to the free online journal for TCM at Times > http://www.chinesemedicinetimes.com > > Help build the world's largest online encyclopedia for Chinese medicine and > acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia > > > and adjust > accordingly. > > Messages are the property of the author. Any duplication outside the group > requires prior permission from the author. > > Please consider the environment and only print this message if absolutely > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2010 Report Share Posted March 30, 2010 One insurance company informed me to resubmit the same claim with a letter of explanation and highlighting (in yellow) the section in question. Â You would add the '25' and highlight it along with the date, billing amount. Good luck. --- On Mon, 3/29/10, Joy Keller <JKellerLAc wrote: Joy Keller <JKellerLAc Re: insurance billing question Chinese Medicine Monday, March 29, 2010, 4:51 PM Â Since they've already processed that claim, you can't rebill. (Regardless of > whether they've processed the claim, you can't submit a claim twice for the same visit anyway.) Your only option at this point is to follow their appeals process, whatever that may be. Or forget about it and chalk it up to a learning experience. On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com>wrote: > I just billed a company with EM code 99214 and acup 97810 but forgot to put > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > resubmit the 92114 on a seperate claim to get paid for that part of the > visit? Or is it not possible since i already billed it incorrectly? > > thanks for your input! , LAc > > > > > ------------ --------- --------- ------ > > Subscribe to the free online journal for TCM at Times > http://www.chinesem edicinetimes. com > > Help build the world's largest online encyclopedia for Chinese medicine and > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ CMTpedia > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join and adjust > accordingly. > > Messages are the property of the author. Any duplication outside the group > requires prior permission from the author. > > Please consider the environment and only print this message if absolutely > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2010 Report Share Posted March 30, 2010 Joy, I have dealt with many hospital claims, in another job where multiple claims simply get rejected as duplicate. I am unsure if others know that and wanted to make it a point. Usually we would then contact the insurance company by phone and then they would have us resubmit the claim, ignoring the previous ones. You could also just bill for the denied procedure. Michael W. Bowser, DC, LAc Chinese Medicine JKellerLAc Mon, 29 Mar 2010 15:51:30 -0700 Re: insurance billing question Since they've already processed that claim, you can't rebill. (Regardless of whether they've processed the claim, you can't submit a claim twice for the same visit anyway.) Your only option at this point is to follow their appeals process, whatever that may be. Or forget about it and chalk it up to a learning experience. On Mon, Mar 29, 2010 at 2:22 PM, wrote: > I just billed a company with EM code 99214 and acup 97810 but forgot to put > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > resubmit the 92114 on a seperate claim to get paid for that part of the > visit? Or is it not possible since i already billed it incorrectly? > > thanks for your input! , LAc > > > > > --- > > Subscribe to the free online journal for TCM at Times > http://www.chinesemedicinetimes.com > > Help build the world's largest online encyclopedia for Chinese medicine and > acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia > > > and adjust > accordingly. > > Messages are the property of the author. Any duplication outside the group > requires prior permission from the author. > > Please consider the environment and only print this message if absolutely > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2010 Report Share Posted March 30, 2010 Yup. That's why I said refer to the individual insurance company's appeal process because how you go about resolving the problem will vary. There's a semantic, but I think important, difference between the words " resubmit " and " rebill. " For example, in my case, since I bill electronically, any appeals process that requests I resubmit the bill with a letter means I have to send them a hardcopy of a printed HCFA form along with said letter - I can't just rebill electronically for that contested claim. Joy On Tue, Mar 30, 2010 at 8:27 AM, mike Bowser <naturaldoc1wrote: > > Joy, > > I have dealt with many hospital claims, in another job where multiple > claims simply get rejected as duplicate. I am unsure if others know that > and wanted to make it a point. Usually we would then contact the insurance > company by phone and then they would have us resubmit the claim, ignoring > the previous ones. You could also just bill for the denied procedure. > > Michael W. Bowser, DC, LAc > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 I've never understood what the .25 is for, so I just don't use it. When do you use the .25? Chinese Medicine , Kathleen Mathews <kthmathews2003 wrote: > > One insurance company informed me to resubmit the same claim with a letter of explanation and highlighting (in yellow) the section in question. Â You would add the '25' and highlight it along with the date, billing amount. > Good luck. > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc wrote: > > Joy Keller <JKellerLAc > Re: insurance billing question > Chinese Medicine > Monday, March 29, 2010, 4:51 PM > > > > > > > > > > Â > > > Since they've already processed that claim, you can't rebill. (Regardless of > > > whether they've processed the claim, you can't submit a claim twice for the > > same visit anyway.) Your only option at this point is to follow their > > appeals process, whatever that may be. Or forget about it and chalk it up to > > a learning experience. > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com>wrote: > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot to put > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > > > resubmit the 92114 on a seperate claim to get paid for that part of the > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > Subscribe to the free online journal for TCM at Times > > > http://www.chinesem edicinetimes. com > > > > > > Help build the world's largest online encyclopedia for Chinese medicine and > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ CMTpedia > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join and adjust > > > accordingly. > > > > > > Messages are the property of the author. Any duplication outside the group > > > requires prior permission from the author. > > > > > > Please consider the environment and only print this message if absolutely > > > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 The -25 is an indicator that this procedure was done seperately from any other.   If you bill without it, it can be inferred that it was part of the other two and can be ignored (not paid).  I always use -25 with a new injury for an established patient (99212-25) or any evaluation code, for that matter. ________________________________ heylaurag <heylaurag Chinese Medicine Wed, March 31, 2010 8:16:32 AM Re: insurance billing question  I've never understood what the .25 is for, so I just don't use it. When do you use the .25? Traditional_ Chinese_Medicine , Kathleen Mathews <kthmathews2003@ ...> wrote: > > One insurance company informed me to resubmit the same claim with a letter of explanation and highlighting (in yellow) the section in question.  You would add the '25' and highlight it along with the date, billing amount. > Good luck. > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc@ ...> wrote: > > Joy Keller <JKellerLAc@ ...> > Re: insurance billing question > > Monday, March 29, 2010, 4:51 PM > > > > > > > > > >  > > > Since they've already processed that claim, you can't rebill. (Regardless of > > > whether they've processed the claim, you can't submit a claim twice for the > > same visit anyway.) Your only option at this point is to follow their > > appeals process, whatever that may be. Or forget about it and chalk it up to > > a learning experience. > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com>wrote: > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot to put > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > > > resubmit the 92114 on a seperate claim to get paid for that part of the > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > Subscribe to the free online journal for TCM at Times > > > http://www.chinesem edicinetimes. com > > > > > > Help build the world's largest online encyclopedia for Chinese medicine and > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ CMTpedia > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join and adjust > > > accordingly. > > > > > > Messages are the property of the author. Any duplication outside the group > > > requires prior permission from the author. > > > > > > Please consider the environment and only print this message if absolutely > > > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 It is used when billing for office visit/intake.  If I don't show this, the insurance company will not pay for that section of my bill. --- On Wed, 3/31/10, heylaurag <heylaurag wrote: heylaurag <heylaurag Re: insurance billing question Chinese Medicine Wednesday, March 31, 2010, 9:16 AM  I've never understood what the .25 is for, so I just don't use it. When do you use the .25? Traditional_ Chinese_Medicine , Kathleen Mathews <kthmathews2003@ ...> wrote: > > One insurance company informed me to resubmit the same claim with a letter of explanation and highlighting (in yellow) the section in question.  You would add the '25' and highlight it along with the date, billing amount. > Good luck. > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc@ ...> wrote: > > Joy Keller <JKellerLAc@ ...> > Re: insurance billing question > > Monday, March 29, 2010, 4:51 PM > > > > > > > > > > > > > > > > >  > > > > > > > > > > Since they've already processed that claim, you can't rebill. (Regardless of > > > whether they've processed the claim, you can't submit a claim twice for the > > same visit anyway.) Your only option at this point is to follow their > > appeals process, whatever that may be. Or forget about it and chalk it up to > > a learning experience. > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com>wrote: > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot to put > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > > > resubmit the 92114 on a seperate claim to get paid for that part of the > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > Subscribe to the free online journal for TCM at Times > > > http://www.chinesem edicinetimes. com > > > > > > Help build the world's largest online encyclopedia for Chinese medicine and > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ CMTpedia > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join and adjust > > > accordingly. > > > > > > Messages are the property of the author. Any duplication outside the group > > > requires prior permission from the author. > > > > > > Please consider the environment and only print this message if absolutely > > > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 My understanding is that 97810 includes an aspect of consultation, however, if you need more than this small included amount, you need to use the specifier ..25. If you did a consult only, and no acupuncture, you would not use .25 My understanding also is that you can rebill and insurance, it's actually pretty routine. Regards, Angela Pfaffenberger, Ph.D. angelapfa www.InnerhealthSalem.com Phone: 503 364 3022 - heylaurag Chinese Medicine Wednesday, March 31, 2010 8:16 AM Re: insurance billing question I've never understood what the .25 is for, so I just don't use it. When do you use the .25? Chinese Medicine , Kathleen Mathews <kthmathews2003 wrote: > > One insurance company informed me to resubmit the same claim with a letter of explanation and highlighting (in yellow) the section in question. Â You would add the '25' and highlight it along with the date, billing amount. > Good luck. > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc wrote: > > Joy Keller <JKellerLAc > Re: insurance billing question > Chinese Medicine > Monday, March 29, 2010, 4:51 PM > > > > > > > > > > > > > > > > > Â > > > > > > > > > > Since they've already processed that claim, you can't rebill. (Regardless of > > > whether they've processed the claim, you can't submit a claim twice for the > > same visit anyway.) Your only option at this point is to follow their > > appeals process, whatever that may be. Or forget about it and chalk it up to > > a learning experience. > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com>wrote: > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot to put > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. Can I > > > resubmit the 92114 on a seperate claim to get paid for that part of the > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > Subscribe to the free online journal for TCM at Times > > > http://www.chinesem edicinetimes. com > > > > > > Help build the world's largest online encyclopedia for Chinese medicine and > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ CMTpedia > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join and adjust > > > accordingly. > > > > > > Messages are the property of the author. Any duplication outside the group > > > requires prior permission from the author. > > > > > > Please consider the environment and only print this message if absolutely > > > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 so do you submit it as 97810.25? k On Wed, Mar 31, 2010 at 1:57 PM, Angela Pfaffenberger, PH.D. < angelapfa wrote: > > > My understanding is that 97810 includes an aspect of consultation, however, > if you need more than this small included amount, you need to use the > specifier .25. > If you did a consult only, and no acupuncture, you would not use .25 > My understanding also is that you can rebill and insurance, it's actually > pretty routine. > > Regards, > Angela Pfaffenberger, Ph.D. > > angelapfa <angelapfa%40comcast.net> > > www.InnerhealthSalem.com > > Phone: 503 364 3022 > > - > heylaurag > To: Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com> > Wednesday, March 31, 2010 8:16 AM > Re: insurance billing question > > I've never understood what the .25 is for, so I just don't use it. When do > you use the .25? > > --- In Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com>, > Kathleen Mathews <kthmathews2003 wrote: > > > > One insurance company informed me to resubmit the same claim with a > letter of explanation and highlighting (in yellow) the section in question. > Â You would add the '25' and highlight it along with the date, billing > amount. > > Good luck. > > > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc wrote: > > > > Joy Keller <JKellerLAc > > Re: insurance billing question > > To: Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com> > > Monday, March 29, 2010, 4:51 PM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Â > > > > > > > > > > > > > > > > > > > > Since they've already processed that claim, you can't rebill. (Regardless > of > > > > > whether they've processed the claim, you can't submit a claim twice for > the > > > > same visit anyway.) Your only option at this point is to follow their > > > > appeals process, whatever that may be. Or forget about it and chalk it up > to > > > > a learning experience. > > > > > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com > >wrote: > > > > > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot to > put > > > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. > Can I > > > > > resubmit the 92114 on a seperate claim to get paid for that part of the > > > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > > > > > Subscribe to the free online journal for TCM at Times > > > > > http://www.chinesem edicinetimes. com > > > > > > > > > > Help build the world's largest online encyclopedia for Chinese medicine > and > > > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ > CMTpedia > > > > > > > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join > and adjust > > > > > accordingly. > > > > > > > > > > Messages are the property of the author. Any duplication outside the > group > > > > > requires prior permission from the author. > > > > > > > > > > Please consider the environment and only print this message if > absolutely > > > > > necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2010 Report Share Posted March 31, 2010 No, 97810 is acupuncture including consult, if you want to bill consult additionally you bill 99213.25 If you do only a consult and no acupuncture you bill 99213 without specifier. Regards, Angela Pfaffenberger, Ph.D. angelapfa www.InnerhealthSalem.com Phone: 503 364 3022 - " " <Chinese Medicine > Wednesday, March 31, 2010 11:01 AM Re: insurance billing question so do you submit it as 97810.25? k On Wed, Mar 31, 2010 at 1:57 PM, Angela Pfaffenberger, PH.D. < angelapfa wrote: > > > My understanding is that 97810 includes an aspect of consultation, > however, > if you need more than this small included amount, you need to use the > specifier .25. > If you did a consult only, and no acupuncture, you would not use .25 > My understanding also is that you can rebill and insurance, it's actually > pretty routine. > > Regards, > Angela Pfaffenberger, Ph.D. > > angelapfa <angelapfa%40comcast.net> > > www.InnerhealthSalem.com > > Phone: 503 364 3022 > > - > heylaurag > To: > Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com> > Wednesday, March 31, 2010 8:16 AM > Re: insurance billing question > > I've never understood what the .25 is for, so I just don't use it. When do > you use the .25? > > --- In > Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com>, > Kathleen Mathews <kthmathews2003 wrote: > > > > One insurance company informed me to resubmit the same claim with a > letter of explanation and highlighting (in yellow) the section in > question. > Â You would add the '25' and highlight it along with the date, billing > amount. > > Good luck. > > > > --- On Mon, 3/29/10, Joy Keller <JKellerLAc wrote: > > > > Joy Keller <JKellerLAc > > Re: insurance billing question > > To: > > Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com> > > Monday, March 29, 2010, 4:51 PM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Â > > > > > > > > > > > > > > > > > > > > Since they've already processed that claim, you can't rebill. > > (Regardless > of > > > > > whether they've processed the claim, you can't submit a claim twice for > the > > > > same visit anyway.) Your only option at this point is to follow their > > > > appeals process, whatever that may be. Or forget about it and chalk it > > up > to > > > > a learning experience. > > > > > > > > On Mon, Mar 29, 2010 at 2:22 PM, <@ gmail.com > >wrote: > > > > > > > > > I just billed a company with EM code 99214 and acup 97810 but forgot > > > to > put > > > > > a " 25 " after the 99214. So of course, did not get paid on the 99214. > Can I > > > > > resubmit the 92114 on a seperate claim to get paid for that part of > > > the > > > > > visit? Or is it not possible since i already billed it incorrectly? > > > > > > > > > > thanks for your input! , LAc > > > > > > > > > > > > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > > > > > Subscribe to the free online journal for TCM at Times > > > > > http://www.chinesem edicinetimes. com > > > > > > > > > > Help build the world's largest online encyclopedia for Chinese > > > medicine > and > > > > > acupuncture, click, http://www.chinesem edicinetimes. com/wiki/ > CMTpedia > > > > > > > > > > > > > > > http://groups. / group/Traditiona l_Chinese_ Medicine/ join > and adjust > > > > > accordingly. > > > > > > > > > > Messages are the property of the author. Any duplication outside the > group > > > > > requires prior permission from the author. > > > > > > > > > > Please consider the environment and only print this message if > absolutely > > > > > necessary. Quote Link to comment Share on other sites More sharing options...
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