Wiki Help coding Hep B Vaccine

[kschutte63]

Hi, our practice has a pt who has Medicare as her only insurance and is also a nursing student. She came to our office in August 2012 for her 1st Hep B Vaccine, which I billed and Medicare paid for. She did not show up for the 2nd shot until 10/3/12! Per the Dr, the series needed to be started over. I had her sign an ABN, because I did not think Medicare would cover it - we noted the chart, the pt "just forgot" to come for the 2nd shot.

I billed the 2nd "1st shot" with the appropriate modifier and of course, Medicare did not pay.

Does anyone have experience or know of documentation that shows Medicare would have paid if I didn't add the ABN Modifier?

Thanks for all help and advise !!