Wiki Unbundling?

[toliverson]

If a Medicare beneficiary has two benign lesions treated in the same encounter with one having a diagnosis that is allowed by Medicare and the other is not. Would separating the treatments into two chart notes (one billed to Medicare and one patient pays for) be considered unbundling since they're both 17110? What if we have a signed ABN form marked not to bill Medicare for the one elective treatment and they paid at check out? Any suggestions???

 

[jholt12]

Hi, I would not make two separate visits for this patient. You should have the patient sign an ABN and bill both procedures together using the modifier showing that you have a signed ABN from the pt. Then when they deny it you bill pt and if you like have the pt pay at check out since you know it won't be covered. That way you covered all your basis; your not making too visits, your billing Medicare appropriately, you have your ABN, and you have your payment from the pt.