E/M Coding Alert - 2009 Issue 27
PART B MYTHBUSTER: Check Secondary Coverage Before Billing Preventive Service
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Article Overview
This article covers Medicare Part B billing for preventive services when the patient is beyond the initial welcome visit period and may have supplemental or secondary coverage. It focuses on the relationship between Medicare denial, crossover billing, and follow-up submission to other payers, and it is aimed at medical billing and coding staff who need to determine whether secondary coverage may reimburse preventive services.
Why This Topic Matters
It helps billing professionals understand when Medicare must be billed first, how secondary coverage can affect payment for preventive services, and why assumptions about noncoverage can lead to avoidable patient collection issues.
What You Will Learn
- How Medicare denial can affect billing workflow for preventive services
- How secondary or supplemental coverage may change payment for preventive visits
- Why some practices verify other coverage before seeking payment from the patient
- How billing staff think about crossover and follow-up submission after Medicare processes the claim
Who Should Read This
- Medical billers
- Coding staff
- Revenue cycle personnel
- Practice managers
Modifiers Discussed
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