Wiki 97606 reimbursement

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jnabiullina

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OUR DOCTOR SEES PATIENTS IN THE NURSING HOME (POS: 31)...
RECENTLY WE'VE SUBMITTED CLAIMS FOR WOUND V.A.C.

Dx supports medical necessity per LCD... :cool:

Medicare sent denial: A facility is responsible for payment to outside providers who furnish these services/supplies/drugs to its patients/residents :eek:


Any ideas why and how to get paid? similar cases maybe? Thank you very much!:)
 
jnabiullina said:
OUR DOCTOR SEES PATIENTS IN THE NURSING HOME (POS: 31)...
RECENTLY WE'VE SUBMITTED CLAIMS FOR WOUND V.A.C.

Dx supports medical necessity per LCD... :cool:

Medicare sent denial: A facility is responsible for payment to outside providers who furnish these services/supplies/drugs to its patients/residents :eek:


Any ideas why and how to get paid? similar cases maybe? Thank you very much!:)
Click to expand...

I believe this would fall under consolidated billing. Basically, while a patient is enrolled in the SNF, that facility is responsible for payment for some services; you will have to get their info and bill them. There is lots of info here on this topic:

http://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/Index.html

HTH!
 
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