General Surgery Coding Alert - 2019 Issue 1
Reader Question: Will Medicare Pay for Non-Covered Workers' Comp Visits?
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Article Overview
This short Q&A discusses coordination of benefits between workers’ compensation and Medicare when a work-related encounter is denied or only partially paid by the workers’ compensation insurer. It summarizes the article’s general guidance on primary payer order, claim denial documentation, and Medicare’s role in covering eligible services for audiences that bill or manage claims involving workplace injuries and Medicare beneficiaries.
Why This Topic Matters
Billing staff, coders, and revenue cycle teams need to understand payer order and denial handling so claims are submitted to the appropriate payer and eligible services are not overlooked.
What You Will Learn
- How the article frames Medicare and workers’ compensation payer coordination
- What documentation is mentioned when a workers’ compensation claim is denied
- Which broad types of services are discussed in relation to Medicare coverage after denial
- How the article presents the role of Medicare in a workers’ compensation-related encounter
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle personnel
- Practice managers
- Emergency department billing teams
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