Advanced Search

Podiatry Coding & Billing Alert

Reader Question:

Pay Attention to Month, Not Year, With Birthday Rule

Published on Fri Feb 10, 2012

Question: I just received a call from a patient's parent claiming that we didn't follow the birthday rule when we billed the mother's insurance. The mother's birthday is 09/30/1965 and the father's birthday is 11/30/1958. The mother says that since the father is older, we should have billed his insurance rather than hers. What is the birthday rule and whose insurance should we have billed?Iowa SubscriberAnswer: You'll only follow the "birthday rule" in determining which parent's insurance is primary when the child is covered under the insurance plans for both parents. You'll find this rule typically applies to children whose parents are not separated or divorced, or dependent children of parents with joint custody.How it works: The birthday rule says that for a dependent child of parents who are not legally separated or divorced, the insurance of the parent whose birthday falls earlier in the year is the primary payer.The [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All