New York State's new managed care provider FIDELIS does not cover family planning services. If a patient with FIDELIS is seen for family planning, you are to bill it to Medicaid. This is fine for stand alone services like depo shots etc, but it's confusing when you treat more than one condition on a day. I sent them the following question to obtain clarification:
The response I received from Fidelis was:If a patient is seen for an office visit where the doctor manages disease processes as well as writes a prescription for birth control pills, would that E/M be billed to Fidelis or to Medicaid? For example: 99213 with 401.9, 272.4, V25.49
This does not seem right, I have never split up an e/m and reported it with partial dx to one insurance and partial dx to another. Is anyone else familiar with this? I asked them to send supporting documentation.You can bill one to Fidelis with the medical diagnosis code and the other to Medicaid with the birth control diagnosis.