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Hi,

We have a few claims who denied payment because of reason code CO-96 (Non covered charges ) from Primary as well as Secondary insurance. Can we bill this to patient?

Please advise.

Jay
 
This will depend on the payer. If it is Medicare you must have obtained an ABN prior to the procedure and used a GA modifier when the claim was originally submitted. Other payers may require some similar form of a waiver prior to the procedure. If the EOB indicates do not bill patient then of course you cannot.
 
This will depend on the payer. If it is Medicare you must have obtained an ABN prior to the procedure and used a GA modifier when the claim was originally submitted. Other payers may require some similar form of a waiver prior to the procedure. If the EOB indicates do not bill patient then of course you cannot.

Thank you.
 
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