Forum - Questions & Answers

Sep 11th, 2018 - austin

NHP-RI CPT 64450-XS denied as non coverd

I need some suggestion we are billing 4 units for CPT 64450-XS to NHP-RI and they are denying it as we cannot bill more then 1 unit for this service. But as per CMS we can bill 10 units in a same day.

I have tried almost everything but cannot get reimburse this code. I need some suggestion from you guys.

Thank You

Sep 27th, 2018 - DDIAZ 2 


NHP-RI not only is not Medicare, and therefore not bound by CMS coverage guidelines, but not insurance at all. It's an HMO (Health Maintenance Organization) that is an alternative to traditional insurance. I would suggest calling them to find out about their coverage requirements and guidelines regarding this.

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