Wiki Medicare Billing Question!!!

[AmandaM2153]

So this isn't a coding question, but I am hoping someone would be able to shed some light on my question!!

The clinic I work for is an FQHC - so when we bill for provider's E/M codes we bill to Medicare Part A, and labs go to Medicare Part B - and we then get reimbursed more with Mcr A.

So now the question I have, some of our providers see patient's in the hospital nextdoor - Inpatient's I know we still bill Medicare Part A, but what if the patient is an Outpatient/Observation?? I worked in a hospital before and we billed Medicare Part B for that... but does our FQHC status hold true for the Observation patient's also to bill Part A???

I hope this makes sense!!!

Thank you in advance!!

 

[dmetz]

I work for an FQHC too. We bill the physician charges when they see the patient in a hospital or observation setting, to Part B. The charges that get billed to Part A are in the clinic or nursing home visits.

dmetz

 

[AmandaM2153]

Thank you so much for your help!!

Now another question - whoever set up our new system entered the revenue codes in ALL WRONG.... how can I find a list of charges and revenue codes - or at least the group of revenue codes accepted by Medicare.... Like right now I am looking for a Revenue Code for a 93000 code.

And also how do I find out which codes Medicare allows seeing they are different than what is in the code book....

I am so new to Medicare and it is kicking my butt right now!

Thank you for the help!!!

 

[pjorwin]

Hi Amanda,
Do you have access to Medicare direct data entry?
Paula