Specialty Ideas

30 Vote

Medical Claim Form

If a CPT code is performed multiple times, we should be able to reflect that on the CMS 1500 form. We should be able to list one procedure (CPT 21248 or CDT 6010) on the medical claim form (line 24D), the number of times it was done (line 24G), and the charges should be a multiple of the two (line 24F). I've made several calls and have been told this is the way the system was developed and that it is a programming issue.If a medical carrier pays the 1st line at 100 percent for an operation, and each subsequent line is paid at 50, we would lose a tremendous amount of money by itemizing 6 implants. The first would be paid at 100% and the subsequent 5 would be paid at 50%. We should be reimbursed at 100% for all 6. Please reformat the way the system pulls codes into the CMS 1500 form so we can maximize our reimbursement. This formatting error makes OMS Vision practically useless for printing medical claim forms. Has anyone figured a way around this?
  • Sajata Strong
  • Feb 4 2019
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  • +27