Timely filing and authorization missing denial – complete overview

TFL denial reasons codes and action plan CO – 29 – The time limit for filing has expired. Amerigroup/BCBS of WNY: Timely filing 120 days from the DOS. Contact Provider Relations to discuss timely filing denials. HealthFirst: Children’s timely filing claim...

CPT 0059U, 0060U, 0062U -Oncology Merkel Cell Carcinoma

CPT Code and Description 0059U – Oncology (Merkel Cell Carcinoma), Detection Of Antibodies To The Merkel Cell PolyomaVirus Capsid Protein (Vp1), Serum, Reported As Positive Or Negative. 0060U – Twin Zygosity, Genomic-Targeted Sequence Analysis Of...

CPT Code 64490, 64491, 64492, 64493

CPT Code and Description 64490 (cervical or thoracic) or 64493 (lumbar or sacral) reports a single level injection performed with image guidance (fluoroscopy or CT). Procedures performed under ultrasound guidance are not covered. 64491 or 64494 describes a second...

What Are Services Covered By Medicaid?

Covered Services: a. Except for specific laboratory tests identified under non-covered services, the Division of Health Care Financing and Policy (DHCFP) reimburses organ or disease oriented panels, therapeutic drug assays, evocative/suppression testing, clinical...

CPT 29824, 29827, 29828 – Arthroscopic Rotator Cuff Repair

CPT Code and Descripiton ▪ 29824 – Arthroscopic claviculectomy including distal articular surface ▪ 29827 – Arthroscopic rotator cuff repair ▪ 29828 – Biceps tenodesis Coding and Billing Guidelines. Description of Special Study: The CERT review contractor conducted a...

CPT 93880, 93882, 93886, 93888

Cerebrovascular Arterial Studies (93880-93893)  93880 Duplex scan of extracranial arteries; complete bilateral study 93882 Duplex scan of extracranial arteries; unilateral or limited study (To report common carotid intima-media thickness (IMT) study for evaluation...