Professional vs Institutional Claims for Comprehensive Assessment

karenhecksel 1 year ago in Billing/Electronic Modules updated by Stephanie B 1 year ago 5

Did something change for facilities that bill Comprehensive Assessments? Previously I billed all claims as Institutional and yesterday I received a denial from MA for a comp claim stating I used the wrong form. Can someone help me? 

We've always billed Comp Assessments on a professional claim except for Blue Plus as they wanted them on a UB04 claim. I guess I haven't tried to bill any other payer on a UB04 form so I can't say but thought I'd offer my input. 

I am having the same issue.  I think that the comps. should go on a HCFA and not a UB04.  I know for Prime West that is how I have to bill all comp. assessments.

We got the same denials this last month. We have resubmitted these assessments on a 1500 form and for the most part they have all paid. I wish that payers would send something out before they change billing processes. This has been an ongoing problem for us this year!

We've found that payers are starting to require comps, treatment coordination (T1016 U8 HN) and peer recovery support (H0038 U8) to be billed on an 837P format.  It's been a pain in the rear.  I saw no communication from any payer at the start of this year or late last year about this change.  My team found this out when they called on denied claims.

When billing on 1500, Can the NPI-2 go in rendering provider 24J field?