Forum - Questions & Answers

Oct 21st, 2015 - vochrisq 3 

Humana Military Tricare reimbursement

I billed an Outpt 99243 (57) and 44970. They paid for the 44970 but did not pay the 99243 stating medical visit included.
Is that correct? Any help would be great! Thanks

Oct 21st, 2015 - rphelps 615  1 

re: Humana Military Tricare reimbursement

Is this a 90 day global procedure? If not your modifier would be 25. Was the decision to perform the procedure the same day day as the surgery? Maybe they don't recognize the consult code since Medicare does not.

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