ATTN: Ophthalmologists: Procedure Code 13133 Can Now be Billed

November 14, 2012

Procedure code 13133 has been added as an allowed code for Ophthalmologists with the effective date of 9/1/2010 and can be billed for ophthalmology claims. If claims with this procedure code denied incorrectly for the following reason, providers may now re-bill affected claims:

  • MIHMS Rule – 150 - No contract term found for service
  • CARC - 185 - The rendering provider is not eligible to perform the service billed. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Please note: Re-submitted claims must meet timely filing guidelines as outlined in Chapter I of the MaineCare Benefits Manual. Please contact your Provider Relations Specialist with questions related to timely filing.