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C section and BTL-each has to go to sep carrier

  1. #1
    Default C section and BTL-each has to go to sep carrier
    Medical Coding Books

    I have a patient that has Metroplus for most medical services except family planning/sterilization - that has to go to NYS Medicaid. She has a c-section and BTL on same dos. (in this case the BTL is an add-on code). Do I split the claim or send a claim with both codes to each carrier and let them pay what they are responsible for? I am not familiar with this scenario and am wondering if anyone has any experience with these carriers. I checked their respective sites, but didn't see any info re this particular circumstance.

    Any help or guidance is appreciated.



  2. #2
    I would send the total claim to the primary insurance for the C Section and when/if the BTL is denied, then I would send the claim and EOB to NYS Medicaid. Hope this helps

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