Q/A: How Do I Bill a House Call?

Question
If a provider makes a house call to/for a patient, is there a way that it is represented on the claim form?  A modifier, or something else?
Answer
Modifiers are not used to identify that a service was performed in the patient’s home. However, other modifier rules must be followed (e.g., modifier GP …

Q/A: Why is Code 99080 Being Denied when Billed with an E/M Service?

In order to understand and answer the question, “Why code 99080 is being denied when billed with an E/M Service, it is important to first review the requriements of selecting the appropriate level of Evaluation and Management service and how that relates to reporting a 99080 special report service. Continue reading for better understanding.

Increased Therapy Denials Create Administrative Burden

Recently, many healthcare providers have begun to experience a downpour of denials when billing therapy services. The states which seem to be experiencing the most difficulty are Illinois, Oklahoma and Texas, particularly for claims submitted to BCBS plans owned by Health Care Service Corporation (HCSC). Since HCSC also owns Blues …