[Ohioaap-practicemanagers] FW: code 99050(after hours code) for Caresource

[Melanie Farkas]

    We have received a few denials from Caresource for 99051.  The denial code
    OA-233 "Services/charges related to the treatment of a hospital-acquired
    condition or preventable medical error." 
    Our rep has advised us to submit appeals with office notes.  We are still
    waiting for the determination.
    
    
    Jessica Roquet
    Practice Manager
    Pediatric Associates of Mt. Carmel, Inc.
    4371 Ferguson Drive 
    Cincinnati, Ohio 45245
    P 513-752-3650
    F 513-752-3387
    jroquet at pedsmtcarmel.com
    www.pedsmtcarmel.com
    
    
    
    
    -----Original Message-----
    From: Ohioaap-practicemanagers
    [mailto:ohioaap-practicemanagers-bounces at lists.deltaforce.net] On Behalf Of
    Garber MD, Rachel via Ohioaap-practicemanagers
    Sent: Thursday, May 04, 2017 12:19 PM
    To: ohioaap-practicemanagers at lists.deltaforce.net
    Subject: [Ohioaap-practicemanagers] code 99050(after hours code) for
    Caresource
    
    HI,
    We had been getting reimbursement from Caresource using 99050 for after
    hours care , but recently they are rejecting it with stating: " not covered
    based on the insured's noncompliance with policy or statutory conditions".
    Any ideas if we should be using a modifier or is anyone else getting this
    recently?
    Thanks,
     Rachel Garber, MD, FAAP
    University Suburban Pediatrics
    1611 S Green Rd #034
    S. Euclid, Oh 44121
    216-297-2700
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