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| 10/13/2020 @ 1:45:00 PM
Post 1 of 7
Contributor: Amy Gore, Chiefland Medical Center LLC
Is anyone else having an issue getting their bone density screenings paid for through Medicare B? I'm using CPT code 77080 with TC modifier and ICD-10 code Z13.820 or M85.80. Any help would be appreciated!
10/14/2020 @ 6:34:00 AM
Post 2 of 7
Contributor: Barb Freeman, Pawnee County RHC
I haven't checked lately, but the last I knew, Z78.0 was the code they wanted if it was a screening exam.
Barb Barb Freeman, Health Information Management Pawnee County Memorial Hospital 600 I Street Pawnee City, NE 68420 (402)852-2231 Ext. 149 [cid:72499fff-14b5-48d6-a5a4-994e34afb612] E-mail Confidentiality Disclaimer : The information in this e-mail may be privileged and confidential, intended only for the use of the addressee(s) above. Any unauthorized use or disclosure of this information is prohibited. If you have received this e-mail by mistake, please delete it and immediately contact the sender. 10/14/2020 @ 7:50:00 AM
Post 3 of 7
Contributor: Rosemary King, Love Memorial Clinic
we've been having problems too....
Rose ----- Original Message ----- 10/14/2020 @ 8:08:00 AM
Post 4 of 7
Contributor: Patty Harper, InQuiseek Consulting
It looks like there was some tweaking of ICD-10 codes earlier in 2020. Also, there is a 2 year frequency so it could be that the patient has had the scan somewhere else within 2 years or that the dx code is not correct for more frequent scans. See the CMS coverage determination.
https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=256&ncdver=1&CoverageSelection=National&list_type=ncd&bc=gAAAABAABAAA& Patty Harper INQUISEEK CONSULTING Consultant RHIA, CHTS-IM, CHTS-PW, CHC 318-243-2687 (Cell) 866-855-0683 (Secure E-Fax) pharper@inquiseek.com This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. If you are not the intended recipient you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information 10/14/2020 @ 8:33:00 AM
Post 5 of 7
Contributor: Amy Gore, Chiefland Medical Center LLC
Thank you. I'll try that code. Do you have a website or provider portal you use to look up claim status on Medicare B claims?
Thanks, Amy 10/25/2020 @ 12:44:00 PM
Post 6 of 7
Contributor: Ashley Norden, Jefferson Community Health and Life Fairbury Clinic
In order for these to be paid in the RHC a face to face visit needs to be completed with the provider correct? If you do the Bone Density Screening only Medicare will Medicare deny the claim if it meets the criteria of being over 2 years with appropriate diagnosis? Thank You. ---------- Original Comments ---------- Last Post By: Amy Gore, Chiefland Medical Center LLC Thank you. I'll try that code. Do you have a website or provider portal you use to look up claim status on Medicare B claims? 10/26/2020 @ 9:47:00 AM
Post 7 of 7
Contributor: Amy Gore, Chiefland Medical Center LLC
The face to face visit would be billed as an RHC visit to part A and the Bone Density to Medicare part B. However, regardless of the diagnosis code or being over 2 years they are still denying not medical necessary.
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