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Medicaid billing - Missouri MCD to be specific

  1. #1
    Springfield, Mo
    Question Medicaid billing - Missouri MCD to be specific
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    Missouri MCD to be specific. I have heard conflicting things about billing MCD and I hope someone can tell me the actual facts. I have been told that MCD will not pay an E/M code and a procedure at the same office visit, therefore we are only to bill one or the other. But I have also been told to code and bill whatever is documented regardless of what they will pay. Doing it that way has resulted in MCD not paying EITHER one. Does MCD have a rule that they only allow you to bill for one or the other? If so, do we get to choose which one?
    solocoder CPC

  2. #2
    I don't know if different state Medicaid's have different rules or not. I know that if we bill Florida Medicaid for both an office visit and a procedure on the same day, they will pay for one (usually, thankfully, the procedure) and deny the other as inclusive. I don't know if that would be the same for Missouri Medicaid or not. I would say check their provider handbooks or fee schedules, or give them a call for a definate answer.

  3. #3
    Springfield, Mo
    Thanks for the advice Sarreenah. Any idea where I could find this handbook or fee schedule? I've tried online without success.
    solocoder CPC

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