tci Part B Insider - 2009 Issue 27

PART B MYTHBUSTER: Check Secondary Coverage Before Billing Preventive Service

Obtain Medicare denial so the claim can cross over. Myth: You can't bill for a preventive visit for a Medicare patient who's past his first 12 months. Truth: Regular Medicare won't pay for a preventive examination except for the "Welcome to Medicare" exam for a new Medicare patient. But many Medicare patients may have other coverage that will pay for a preventive visit. Once the 12 months have passed, offices feel they cannot report the preventive codes to Medicare because they will not be paid. But many supplemental policies will cover these preventive services. Important: In many cases, you...

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