Wiki Billing 93010 to Medicare

[Cuteyr]

Hi All,

We all know that the CPT 93010 should be billed to Medicare Part B.
But what shd be done in patients who have Medicare Part A only and with patients who has Medicare Part A as Primary and some other Commercial as Secondary.

Please reply....

Thanks

 

[hnroberts]

If you are billing from a non-facility setting, you should not bill Medicare Part A. The patient would be responsible for the charge, or the commercial insurance listed as "secondary" would be responsible. The commercial insurance may deny the claim at first, but you can appeal the denial and remind them that you are a Part B provider and that the patient has Part A only; usually they know this ahead of time. If the patient has Medicare part A only, and you are seeing them in the office, you can always negotiate a payment plan with them based on the Medicare allowable for the 93010. Hope this helps, and good luck!