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HCPCS billed to Medicare

  1. Default HCPCS billed to Medicare
    Medical Coding Books
    I have a question regarding billing supply (HCPCS) codes to Medicare and if they should be billed to the DME or local carrier.

    If a Medicare pt goes in to the orthopedist after spraining their ankle. The physician charges and office visit and applies an ace bandage. Is the ace bandage billed seperately or is its cost included in the office visit charge? A Medicare pt goes to the orthopedist for a post op visit that is still in the global period. The physician applies an ace bandage. The office visit cannot be billed but what about the ace bandage?

    The recently updated DMEPOS listing shows that A6450 (Ace bandage) "Billed to the local carrier if incident to a pyhsician's service(not seperately payable) or if supply for implanted device or implanted DME. If other DME MAC."

    In the examples that I have given would the bandage be billed to DME or the local carrier? Not billed at all?

  2. #2
    From my experience Medicare will not pay for an ACE bandage at all no matter where you bill it to.

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