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Post by puyallupvision on Apr 4, 2017 14:32:36 GMT -6
Ever since ICD-10 kicked in, we have been having problems billing the DME for glasses. I know some things changed with billing and from what we found out we have tried to bill a few pairs but we have never received payment. We don't even get a EOB so that we can try to figure out why its not being adjudicated. Ive tried calling the DME with no luck because "they cant tell me how to bill" I have even reached out to local offices, but it seems like no one bills for post cat glasses anymore. I'm starting to see why. Any help would be greatly appreciated. Thank you.
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Deleted
Deleted Member
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Post by Deleted on Apr 13, 2017 15:26:49 GMT -6
We've had luck with our DME Glasses claims, so I'd be happy to help you! I will send you a message.
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Post by run131 on Sept 22, 2017 12:52:19 GMT -6
We found that things had changed with Medicare and we were no longer able to bill for glasses after cataract as it wasn't part of our contract. We were able to in the past.
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Post by eyeguy on Sept 22, 2017 15:32:04 GMT -6
I haven't billed yet under the new rules for post op glasses, but we used to get paid until the system changed. I just completed my re-credentialing for DME, and if they hadn't had a 'non-refundable' payment in advance, I would not have gone through the hassle because it just isn't worth it to me. First I had to pay around $600 or $700 for the application fee. Second I had to be finger printed at the local Sheriff's office, and the first set weren't acceptable, so I had to go back and be re-finger printed! Then they sent someone out to photograph the office to 'prove' that I actually sold glasses. 32 page application form. I was told all this was due to new rules with Obama Care to prevent fraud. I can only accept patients that I did the follow up post op exams with. I understand this credentialing is only good for 2 (maybe 3) years, at which time I have to re-pay the fee and be re-credentialed.
I haven't even tried to bill yet, but I have a gut feeling it won't be good. I am NOT going through this again, and like I said, I would not have continued with it initially if I hadn't already paid the hundreds of dollars in advance.
If anyone has any tips on billing DME after-cataract surgery glasses, I would really appreciate any information you have.
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Post by run131 on Sept 22, 2017 17:33:55 GMT -6
My only recommendation would be use your modifiers. Medicare loves their modifiers.
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Post by jdoveyk on Oct 16, 2019 23:51:23 GMT -6
Can anyone help with what modifier if any that i can use on V2020 to indicate that pt owns the frames? This is post-cat surgery and we are getting repeat denial on this claim from Cigna asking if the pt owns the equipment.
Thank you!
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Post by bethers711 on Oct 17, 2019 7:08:20 GMT -6
Can anyone help with what modifier if any that i can use on V2020 to indicate that pt owns the frames? This is post-cat surgery and we are getting repeat denial on this claim from Cigna asking if the pt owns the equipment. Thank you! For normal Lens only orders on some insurances we have to use the S0595 "Dispensing new spectacle lenses in patient supplied frame" code for it to be approved. Not sure if that would work here.
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Post by jdoveyk on Oct 17, 2019 9:25:26 GMT -6
Thank you! I will look into that!
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Post by KizerOpt on Oct 31, 2019 8:57:38 GMT -6
I have gotten that too on a new denial. However, we need the ins co to PAY for the frame. It's not a POF. Do you have a code for that?
Karen
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