Yea, there is an endnote for that
What endnote do we deny with for NON-EMC limit reached?
x7015
What spinal region are "Traps" located in?
Cervical
97112- Whole body Vibration?
DENY! 9130. WBV needs to be billed as 97039
Escrow bills are priced at what percent of amount charged?
100%
Make sure to update to 100% when MDP doesnt.
What am I? 97010
Ice/Hot pack
What endnote is used to deny for no signed initial evaluation?
x339
What region is "Scapula" located in?
Shoulder
97012-Manual Traction
DENY! x9130. Manual needs to be billed as 97140
Hospital facilities bills get priced at what percent of amount charged for emergency services?
75%
What am I? 97530
Therapeutic Activities
What endnote do we use to communicate to a provider that the therapy code is secondary?
x3570
What region is "Piriformis" located in?
Sacroiliac / Pelvic
98943 Adjustment to the ribs
Deny! x4060 we need to know if it is part of the Thoracic area or not
What percentage does basic PIP pay for each medical bill?
80% and 20% is claimant responsibility
What am I? 97150
Group Therapy
What do you deny 99072 with?
x11 and x990
How many regions need to be documented for a 98942 to be payable?
5
DATE OF REPORT: 1/1/2022
DOS: 1/1/2022
Date received:2/4/2022
Is an Escrow bill privy to Escrow benefits?
Nope! If we have a lien or something prior to this bill that need to be paid we would no longer hold escrow for that bill
What percentage of what fee schedule do we use to price CMT?
What am I? 72052
Radiologic examination of cervical spine; 6 views.
If there are no sufficient records for a radiology bill, what do you deny the codes for?
x4052-Radiology reports needed
What region is "Paraspinal" located in?
All of them
What's the billing cycle? 35 of 75
First DOS 2/21/2022
Date sent 3/16/2022
Sent on day 23 so this provider has a 35 day billing cycle
What fee schedule do we use for identified secondary therapy code?
Can a provider bill 99211 for taking vitals and an examination of the spine for an adjustment?
Nope! Vitals is not enough for an evaluation code and an exam of the spine is included in the adjustment code.