Wiki 90791

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Pkirsch1

Networker
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87
Location
Bristol, CT
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Hello,
90791 denied for using twice in 365 days, but it was billed by 2 different Providers/NPI's.

Is it because it's billed under the same facility? Would the dx matter?

Thank you.
 
Usually the rules are payer specific. I know Medicare and our state Medicaid have slightly different frequency guidelines. We even get some denials if there is a 90791 done by a different facility within the allowed time frequency.
 
Pkirsch
They must be on different illness or disease to use separately by differ providers.
i hope this info is helpful
Lady T
 
TThivierge said:
Pkirsch
They must be on different illness or disease to use separately by differ providers.
i hope this info is helpful
Lady T
Click to expand...
Thank you for clarifying Lady T!
ckeeney said:
Usually the rules are payer specific. I know Medicare and our state Medicaid have slightly different frequency guidelines. We even get some denials if there is a 90791 done by a different facility within the allowed time frequency.
Click to expand...
Thank you!
 
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