tci Medicare Compliance & Reimbursement - 2010 Issue 6
YOUR PART B QUESTIONS ANSWERED: Coding for Supplies Depends On Place of Service
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Article Overview
This Q&A-style article explains several Medicare Part B coding topics that affect office and outpatient billing. It discusses when supplies may be considered included in payment, how current diagnoses are used to support an E/M visit, why an H&P is not separately billable in certain situations, and how locum tenens claims are identified for Medicare. The article is useful for coders, billers, and physician practices that need general guidance on office-based services and payer-specific billing rules.
Why This Topic Matters
These topics affect whether common office services can be billed separately, how claims are supported, and how claims are routed under Medicare and some commercial payer policies.
Article Sections
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Coding for supplies depends on place of service
Discusses office-based supplies, place of service considerations, and differences between Medicare and some private payer approaches.
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Use current diagnosis to support E/M visit
Covers diagnosis selection for an evaluation and management visit tied to ongoing patient care and a same-day procedure.
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No global isn't an H&P billing green light
Addresses preoperative history and physical services, global package considerations, and payer coverage variation for certain visits.
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Link modifier Q6 to locum tenens claims
Explains temporary physician coverage claims, Medicare billing under a replacing physician, and general payer variability for substitute services.
What You Will Learn
- How office supply reporting can vary by payer and place of service
- How diagnosis selection relates to an E/M visit when a procedure is also performed
- How preoperative visits relate to procedure payment and global packages
- How locum tenens services are identified on Medicare claims
Who Should Read This
- Medical coders
- Billing staff
- Physician office practices
- Revenue cycle teams
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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