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2737Re: [MedicalBillers] Re: CPT 95117

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  • Joktan Edison
    Nov 1, 2007
      Thanks Barbara/Melinda, I really appreciate your help.

      Dont work hard and have a great month ahead!!!!

      --- B Burgess <granbfly@...> wrote:

      > Exactly. Doesn't matter if you gave two or ten
      > allergy shots. The code is still 95117 ONCE ( and
      > if your other payors have been reimbursing what you
      > have billed incorrectly, it would be prudent to
      > refund the payments ! )
      >
      > Thanks Melinda. I was trying to get the CPT
      > assistant article but, like all of us probably are,
      > I am busy with end of month !
      >
      > Barbara
      >
      > Melinda <melindadocsmith@...> wrote:
      >
      > Multiple allergy shots
      >
      > Q If I give two allergy shots to a patient on the
      > same day, should I
      > code 95115 and 95117, or just 95117?
      >
      > A You should code 95117 for two or more injections.
      > Code 95115 should be
      > used only when a single injection is given on a date
      > of service. Code
      > 95117 should be reported just once per patient per
      > date of service.
      >
      > http://www.aafp.org/fpm/20060900/coding.html
      > <http://www.aafp.org/fpm/20060900/coding.html>
      >
      > Melinda Brown, CMBS
      > Ins Biller
      >
      > --- In MedicalBillers@yahoogroups.com, Joktan Edison
      > <ejoktan@...>
      > wrote:
      > >
      > > Barbara,
      > >
      > > We are currently billing CPT 95117 with 2 units,
      > > however UHC pays only 1 unit and not for other
      > units.
      > >
      > > Can't we use any modifier like colonoscopy code
      > (what
      > > was discussed today). Apart from that all other
      > > insurance pays for both the units and it is only
      > UHC
      > > does not.
      > >
      > >
      > > --- B Burgess granbfly@... wrote:
      > >
      > > > Then you would bill 95117 once only. The code
      > > > description is for "two or more" injections.
      > 95115
      > > > would be for a single injection. It's kinda like
      > > > the colonoscopy code questions on the group
      > today.
      > > > You don't bill in individual units becase the
      > code
      > > > description IS for more than one.
      > > >
      > > > Barbara Burgess, RN, CPC, ACS-EM
      > > >
      > > > Joktan Edison ejoktan@... wrote:
      > > > Barbara, we are giving two shots.
      > > >
      > > > --- B Burgess granbfly@... wrote:
      > > >
      > > > > How many allergy shots are you giving ?
      > > > >
      > > > >
      > > > >
      > > > > ejoktan ejoktan@... wrote:
      > > > > We bill 2 units for the above mentioned
      > > > > CPT, however UHC only pays for
      > > > > 1 unit and for the other one they request
      > > > additional
      > > > > documentation in
      > > > > order proof this is medical necessity.
      > > > >
      > > > > Any feedback how to get this paid one shot
      > without
      > > > > any paper work would
      > > > > be appreciated.
      > > > >
      > > > > Looking forward for any kind of suggestion to
      > > > handle
      > > > > this with UHC.
      > > > >
      > > > >
      > > > >
      > > > >
      > > > >
      > > > >
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