Wiki Medicare Tetanus and clindamycin denial

Madcoder

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Scenario:

Two seperate patients.

1st patient given Rocephin and Clindamycin injection for severe chest infection. All injection administrations were paid and the Rocephin paid but not the Clindamycin (S0077). Anyone know why??

2nd patient given Tetanus injection (90714) after cutting herself on door knob. (913.0, V06.5)Medicare denied (PR-96). I was under the understanding Medicare didn't pay for routine tetanus injections but would if there was a cut or abrasion. Any insight would be great.
 
what I see is that

1. Medicare does not pay on S codes

2. You need and E code for this to get paid by medicare. How was the person hurt??:)
 
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