RNB's
This RNB is used when billing EKG Code 93000
What is RNB CHARGES SPLIT (BL01)?
This is how you handle labs that have a 90 modifier listed.
Remove 90 Modifier (do not send back to Coding).
Form type used to bill E/M codes for Federal policies.
What is 1500 only?
This is the insurance that you need to utilize the podiatry flowchart.
What is Medicare?
This is the insurance you bill the CMS-1500 when the Policy is a YLS, NYC or YLA.
What is GHI (UHC)?
This RNB is used when for a non-covered Medicare CPT code
What is RNB MEDICARE EXCLUDED (CV19)?
This is the option in your bill that you can view the veteran's insurance policy details from IV.
What is (?INX) ?
This occurrence code is used on all Emergency Room visits.
What is Occurrence code 11?
Coder comments that list "routine foot care" for this insurance are not billable.
What is Medicare primary?
This is the bill form that is used when utilizing the MACRO.
What is the UB?
This RNB CODE is used when the provider is only billable on the UB (nurse)
What is RNB BILLED INSTITUTIONAL ONLY BL03?
These providers are needed when billing an procedure/surgery on a facility claim.
What is Operating & Attending?
This procedure is followed when you receive an LCD Edit.
What is bypass the scrubber?
The revenue code used when billing a podiatry CPT (11721) by itself
What is Revenue Code 761?
This is the insurance(s) you list on the UB for below:
Payer Prefix: NYC
Rev. Code 510 - Bill to: GHI
What is GHI/UHC?
This RNB CODE is used when billing E/M codes that are billable on 1500 only (Aetna).
What is RNB BILLED PROFESSIONAL ONLY BL04?
This is the form type that add on codes (90833) are billable.
What is 1500 only?
These insurances require you to crosswalk drug codes (labs).
What is Aetna, Cigna, GEHA, Horizon, UHC & Mailhandlers?
This bill type is used to bill Home Health Care.
What is 341?
This is how you set up your insurance on the UB when the MACRO states Medicare is Primary and Empire/GHI split policy as secondary.
What is Medicare Prime, Empire Secondary and GHI Tertiary?
RNB BL05 - ALL BILLABLE CODES IS USED FOR THESE CPT CODES.
NONE, WE NEVER USE RNB BL05
This is how you handle an encounter that has a GY modifier.
Remove GY from CPT for Commercial insurance. Do not bill CPT to Medicare.
Insurances that require you to crosswalk E/M codes to G0463.
What is Medicare; GHI (non-split); HIP; Emblem, 1100; Healthcare Partners and CMO?
The insurances we cannot bill G codes for Home Health Care.
What are Medigap, Medicare Supplemental, Federal and split policies?
This is the insurance(s) you list on the UB for below:
Payer Prefix: YLS
Rev. Code 510 - Bill to: Empire (then UHC with denial from Empire)
What is Empire Primary and GHI/UHC secondary?