Coding all insurance the same?

jamcculley

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Alvord, TX
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Someone in our office said Medicare will not allow us to bill code 80050 to other insurance companies because "we have to bill everyone the same way." I was taught that we treat all patients in each "class" the same, ie all Medicare the same way, all BCBS the same way, all UHC the same way, all Private Pay the same way, etc. Can someone give me some guidance on this? Thank You
 

JMeggett

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Spokane Valley, WA
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Someone in our office said Medicare will not allow us to bill code 80050 to other insurance companies because "we have to bill everyone the same way." I was taught that we treat all patients in each "class" the same, ie all Medicare the same way, all BCBS the same way, all UHC the same way, all Private Pay the same way, etc. Can someone give me some guidance on this? Thank You

The Medicare rule is that you cannot bill Medicare or Medicare patients for extra things that you don't bill anyone else for. Or that you don't charge Medicare/Medicare patient's more than you do other insurances. NOT that you have to follow Medicare reimbursement rules for all patients. Medicare doesn't allow Consultations codes any longer, so we can't bill them for Consult codes.....but ALOT of other carriers do still pay for Consults and CPT still has those codes in the manual. If we had to follow Medicare for every patient, then every insurance carrier would exactly match Medicare fee schedule. If you find a carrier that will reimburse for 80050, then by all means bill them! Call Medicare, or go on their website, and find out what exactly that rule is that your co-worker is referencing.
Jenna
 
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