tci Part B Insider - 2009 Issue 45

PART B REVENUE BOOSTER: Ensure Tetanus Payment With 5 Guidelines

Get familiar with Medicare's rules from medical necessity to choice of products. Medicare's tetanus injection coverage riddle boils down to one issue: Is there an injury? When administered as a preventive vaccine, Medicare does not cover a tetanus shot. However, if the patient needed a tetanus injection to treat a wound, you've hit coverage criteria. "Medicare will not pay for tetanus shots given to Medicare patients unless there is a current injury diagnosis reported," according to Lisa Curtis, CPC, CEMC, of Boulder Medical Center in Colorado. Tip: Any wound that causes a break in the skin potentially will...

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