Dx Codes
Medical or Routine
If medical what is it?
Medical or Routine
If medical what is it?
H52.13
Routine!
92015
Refraction
XSB148564853
BCBS
A patient comes in for an annual exam and ref. They have Aetna with NO routine coverage and Davis. The Dr. Codes H52.13 as the only diagnosis code. What order do we file the claim?
Straight to Davis
It is the OBS billers responsibility to collect outstanding balances from the patient.
False
H40.xx
Medical, Glaucoma
92014
Comp Exam, Existing pt
915886324
United Healthcare
A patient comes in for an annual exam and ref with Medicare, Tricare for life, and Davis. The Dr codes H35.00 as the primary DX. What order do we file the claim?
Medicare, Tricare, then Davis
The biller should Audit twice a week no more than 3 days apart.
True
H52.223
Routine!
92250
Fundus Photos
R1584862
Federal BCBS
A patient comes in for an exam and ref. They have VSP and Medicaid. The doctor codes with H52.13. What order do we file?
VSP then Medicaid.
The OBS biller is able to change the diagnosis.
False
E11.xx
Medical, Diabetes
99213
E&M Level 3 Established
1EG4TE5MK73
Medicare
A patient comes in for because they have a metal shaving in their eye. No refraction was done. The patient only has EyeMed and VSP. What order do we file the claim?
Trick Question! The pt does not have medical INS on file. This would go on the communication board to confirm. If they don't, balance will be patient responsibility.
The OBS biller can send the Dr a message if an error is found in CPT or DX codes.
True.
H33.xx
Medical, Retinal issue
92012
10124586345
Aetna
A patient come in for an annual exam and refraction. They have BCBS with a routine benefit and VSP. The Dr. codes the exam with H52.223 as the primary DX and H40.00 as a secondary. What order do we file?
BCBS then VSP
FALSE!!!!