Wiki 88342, 88343 and G0461, G0462

[dclark7]

Has anyone run into the situation billing these codes where Medicare is secondary? If so, how have you handled this? Any suggestions would be appreciated.

 

[daizyluvr]

Medicare and Tricare require the G0461 and G0462 codes whether they are the primary or secondary payer. We have no issues with the primary insurance accepting and paying on those codes.

Thanks!

 

[dclark7]

I know they are required, we're wondering how to bill when Medicare is secondary. Codes 88342, 88343 are billed to the primary, but Medicare won't accept these codes, however they also define them differently so we can't just change the codes to the G codes to bill secondary since the units won't match. We were wondering how other practices handle this.

 

[KMONSANTO]

I know they are required, we're wondering how to bill when Medicare is secondary. Codes 88342, 88343 are billed to the primary, but Medicare won't accept these codes, however they also define them differently so we can't just change the codes to the G codes to bill secondary since the units won't match. We were wondering how other practices handle this.

Is it safe to say, the Primary Carrier is NOT following Medicare guidelines?

We usually bill with the required G code for IHC.