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Medicare patient and covered services with non covered services


Best answers
I have a dilema. I have a patient who was seen for travel counseling and HTN, hyperlipidemia, and allergies. Unfortunately the travel counseling is the primary issue in the HPI and the primary issue in the Assesment and Plan. Is it possible for us to bill this in a way that will not result in a denial to patient responsibility since it is all one note? We are having this debate in our office and I wanted to see if I could get some other feedback or documentaiton.

Thanks! :)

Milwaukee WI
Best answers
Patient responsiblity

If travel counseling was the main focus/reason for the visit then it IS patient responsibility. Trying to code it differently so as to get Medicare coverage is incorrect and possibly fraudulent.

We send these visits to our travel medicine clinic. Patients are told in advance that all fees are patient responsibility and due at time of service.

F Tessa Bartels, CPC, CEMC


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Travel Medicine

Tessa, are Medicare patients required to sign a ABN waiver for the Travel Medicine visit for cpt code ranging from 99401 thru 99404? If so, we bill Medicare with the GA modifier and ask for the payment up front? Please advise.
Thank you much