Forum - Questions & Answers

Dec 23rd, 2015 - Jayavelu

NY Medicaid - Reimbursement for CPT® code 94003

This is in regards to the CPT® code 94003 denied by New York Medicaid stating the code is an invalid CPT® code.

Kindly suggest me an appropriate cross walk code or NY Medicaid reimbursement guidelines for the CPT® code 94003. Thank you so much for your consideration.

Dec 24th, 2015 - LBAROGIANIS 250 

re: NY Medicaid - Reimbursement for CPT® code 94003

How did you bill this code? What was the diagnosis? Were there other codes on the claim? Did you check the fee schedule to make sure this code is on there?

Dec 24th, 2015 - codinqueen 57 

re: NY Medicaid - Reimbursement for CPT® code 94003

As far as I know, you can't bill it along with other E/M codes from 99201 through 99499- see CPT® book note under the code. Have you checked your place of service code to be sure it is correct if you didn't submit it along with an E/M code as listed above?

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