Tag Archives: 96110
Posted on 11. Oct, 2010 by jennifer.godreau.
If you’re ready to bill 96110 and 96110-59, think again.
One office was billing 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) with modifier 59 (Distinct procedural service). BlueCross/BlueShield (BC/BS), UnitedHealthcare (UHC), and other insurers were denying the 96110-59s. “I called BC/BS on 8-19-2010 and was told that we should be using a
Posted on 07. May, 2009 by .
You now have clear-cut policies to apply, including 1 on 96110 pay.
Say goodbye to secret black box bundles and hello to transparent CCI edits for one more insurer.
Adhere to CCI Edits, CMS Modifier Guidelines
Effective April 20, “CIGNA will apply CMS National Correct Coding Initiative (NCCI) Incidental and Mutually Exclusive edits,” according to the payer’s March 2009 Network News. The change puts the insurer’s policy on a level playing field.
For years, CIGNA did their own thing, points out Patti DiSpazio, CPC, business manager at Island Coast Pediatrics in Fort Myers, Fla. “Following UHC’s change, they’re using CCI edits as a barometer.”
In addition, the payer will adopt many CMS modifier guidelines. “Modifier policies being updated are Modifiers 21, 22, 25, 59, 80, 81, 82 and AS,” CIGNA says.
Posted on 30. Jan, 2009 by .
Do you circle 96110 for asking a few questions at a preventive medicine service? Your improper use of the screening code is fueling 96110-well visit bundles.
Instead: Look for these defining factors to avoid unbundling surveillance and ensure meeting 96110’s (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) requirements.