Wiki Commerical Ins Primary Medicare Secondary

ngenschaw

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Can anyone help with this? I have a patient that has Cigna as a primary insurance. Cigna denied the claim, it was a physical (99395) as provider out of network. The claim was then billed to the patient's secondary insurance which is Medicare with the (G0439) and was paid. Any input on this one?

Thank you,

Nancy G.
 
As long as Medicare was provided the primary insurance EOB / denial reason then there should be no issue.
 
The components of the age appropriate physical and G0439 are different so these codes cannot be used interchangeably. Make sure this was truly performed before submitting to medicare.
 
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