I'm hoping somebody out there has a resource about this question. We are provider based so normally split bill our charges w/pos 22. Occasionally we submit a code on both the Medicare A & B sides but B will reject it because it's only paid on the A side. We've run into this with hearing test codes that have work RVUs associated with it for the physician's part, but we're told that it's all included with the part A reimbursement. Does anyone know of a way to look at a code and know whether it's billable on both sides or just one side? I've tried to see if there's a pattern to the status indicators in Addendum B of the Federal Register for OPPS payments and am stumped. SI X (ancillary services) is oftentimes only billable on one side but then there are x-rays with that SI that are billed on both sides. If anyone knows of any hard and fast rules that pertains to provider based billing and when it's not appropriate to split charges, I'd appreciate any information.
Thanks for your help-Sue