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Thread Topic: Assisted Living Facility

Topic Originator: Sam
Post Date October 28, 2020 @ 8:51 AM
Assisted Living Facility Assisted Living Facility

Assisted Living Facility

Assisted Living FacilityOctober 28, 2020 @ 8:51 AM Reply  |  Email Friend   |  |Print  |  Top

We billed last year follow up code 99335 and 99336 for over 4 visits in 5 months with LOC 13.
Now United Healthcare asking for refund because per Medicare not appropriate code.

We used all the time 99324-99327 for follow up and paid by all insurance company. After submitted all documents, they mentioned about Patient has ISNP coverage. also give reference of Medicare claim processing manual Chapter 12 Section 30.6.14

Verified Section 30..looks good to me. but not sure about ISNP coverage.

Please help us if other CPT code goes under such condition??


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