Wiki Billing Secondary to Medicare

Cfoxx1991

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We are billing a patient primary insurance 45378 with Z86.010 for a screening colonoscopy.
The primary made payment but the patient still has a coinsurance which we are billing to Medicare.
Medicare is secondary and they are denying the claim as a non-covered service that is not deemed a medical necessity by the payer.

How do we handle this? please help.
 
We are billing a patient primary insurance 45378 with Z86.010 for a screening colonoscopy.
The primary made payment but the patient still has a coinsurance which we are billing to Medicare.
Medicare is secondary and they are denying the claim as a non-covered service that is not deemed a medical necessity by the payer.

How do we handle this? please help.
I would see if they are looking for dx Z12.11 for a screening colonoscopy. Also, I have seen claims denied for that same reason if they come in too early for their screening (like a pap smear) so you may want to see when they had their last screening colonoscopy.
 
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