🚀 go-pugleaf

Hi Ann and Mark,
Thanks for responding to my problems. I am in the State of VA and our
specially is Family Practice.  We use Medical Manager Software.  I am
familiar with the correlation of cpt and icd9 coding but I don't know what
the e/m codes are if you could explain that one.  The denials have no
consistency to them what works one time doesn't work another.  I now know to
code to 5th level but sometimes there is no 5th level but it is still denied
anyway.  Simple approved Clia tests which we used to be paid for are
suddenly being denied.  One patient who is a diabetic has blood sugar
testing done and its denied because its not necessary.  Ekg's are being
denied with patients having heart problems.  Sometimes it takes 3 months to
have a claim resolved and not always to our benefit.  I acquired this job
when the biller left and I am learning as I go along but it is impossible to
call Medicare for info on unpaid claims. So I keep changing codes and
rebilling if it works I'm happy but I need input on what they are looking
for.

Thank You
Linda