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In-Home Travel Code other than H0046

Rochelle Garcia 10 months ago in Billing/Electronic Modules updated by sarah 10 months ago 3

Does anyone use a different code for travel other than H0046.  Cigna states this code is no longer valid as of 2017 but of course wont advise on an updated code. Just wondering if any one else has come across this.  Client has MA as secondary so I just need them to deny as a non-covered service (if thats the case).  Thanks!

BCBS is paying it for PMAP clients

I'm having the exact same problem with Cigna :/ We keep getting letters in the mail about how they need more information, and when I call them, they tell me the diagnosis needs to be changed. I think they only use it for ABA services, so it's messing things up for our in-home clients who don't have an ASD diagnosis. 

If anyone has any suggestions, that would be much appreciated - I've spent countless hours on the phone with them, and can't seem to get anywhere. Thanks!!

+1

Since they are a commercial payer, they would not pay the travel code. The commercial payer considers travel to be a part of the payment for the appointment billing code. Get them to send you a letter stating their commercial plan (or even that client's plan specifically) does not cover H0046. If you send that to MA along with a copy of your client's signed consent form (stating they are responsible for anything their insurance does not cover) then MA should pay the code.

Because the payer denies with a CO and not PR - MA won't want to pay without the above information.