A Medicare patient can be divorced from a practice the same way that non-Medicare patients are divorced.

Sep 15, 2008
By:
Don Self
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To ensure getting paid for a nurse's injection of a medication when it is billed with an office visit, be sure to list the appropriate CPT or HCPCS (J code) for the drug on the claim.

Medicare's rules are clear that a physician isn't allowed to bill incident-to in the hospital or in any place of service other than the office.

It is within the Medicare rules to forgive or waive the co-insurance and/or deductible in situations where a financial hardship exists, as long as it's not a routine practice for all Medicare patients.

If a Medicare patient is treated both for a motor vehicle accident and a separate condition such as diabetes, file separate office visits on separate claims, one to the auto insurance carrier and one to Medicare for the diabetes.

Not all services require a referring physician's name on a Medicare claim.

With one exception, Medicare doesn't pay for consultations over the phone.

Medicare bundles the local anesthetic and its administration into the procedure.

A nurse practitioner can bill Medicare for consultations, but must do it under his or her own number within a group.
