Forum - Questions & Answers

Jun 23rd, 2014 - behinkson 3 

Emergency Medicaid Diagnosis Code

How to bill procedure 62165 with what emergency medicaid diagnosis code?

Jun 23rd, 2014 - LBAROGIANIS 250 

re: Emergency Medicaid Diagnosis Code

Did the patient come through the emergency room? What is the emergency? Make sure that box 24c indicates emergency. We bill that code but usually it's becasue the patient has a pituitary tumor of some sort.

Jun 23rd, 2014 - behinkson 3 

re: Emergency Medicaid Diagnosis Code

Yes they did the patient only have Emergency Mediciad, we did not had that box 24C checked on the claim. Per TMHP DX 377.49 as not a Emergency Medicaid DX. I would like to know what DX we can use with code 62165.

Jun 24th, 2014 - LBAROGIANIS 250 

re: Emergency Medicaid Diagnosis Code

My understanding of emergency Medicaid is that the patient comes to the er or hospital and is treated for emergency services. Most Medicaids won't pay the physician bill until the hospital submits their bill as emergency, both physician and hospital need to send theirs bill with the emg=y (box 24c) or ub's box 14 & types of admiss 1,2 & 5 and so forth, plus sending records to prove its an emergency. Ecodes and other diagnosis codes that would prove life threatening illness also on the bill. If patient has a brain tumor.. That is a life threatening illness that would compromise the patients health.

anyone else have to deal with Medicaid emergency or alien?

p.S. 377.49 does not look emergency.. Maybe you don't have a case. Did you obtain patient through hospital or need more info on how you all came to decide on performing this surgery

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