Medicare matters - Geriatrics

Medicare matters

Medicare Q & A: Can an emergency department visit be billed if a Medicare patient is triaged by a nurse but leaves before seeing a physician?

October 15, 2009
By:Don Self

In a physician clinic, billing is fee-for-service, but rural health clinics are paid from Medicare Part A on an encounter basis and the encounter has to be performed by a physician, physician assistant, or nurse practitioner.

Medicare Q & A: Because Medicare pays less for a B-12 service than the B-12 costs me, can I have a patient sign an Advanced Beneficiary Notice and then bill the patient separately?

October 15, 2009
By:Don Self

You are not allowed to bill a patient for a covered service that is bundled into another service even if the patient signs an Advanced Beneficiary Notice.

Medicare Q & A: If after surgery, during post-op, a surgeon asks me to see my patient because of abnormal lab results can I bill a consultation for that hospital day?

October 15, 2009
By:Don Self

If a surgeon is asking for your opinion, post-op, on a patient because of abnormal lab results, you can charge a consultation.

Medicare Q & A: If an EKG is taken at the hospital on a patient, but I don't read the results and do my interpretation until the next day, what date should be put on the interpretation

October 15, 2009
By:Don Self

Use the actual date of any service. If interpretation and technical portion are done on separate dates, you would charge on the separate dates.

Medicare Q & A: If I perform a diagnostic test on a patient in my office and then send the test to a physician in another country for interpretation, can I still be paid for the technical portion of the test?

October 15, 2009
By:Don Self

You can be paid for the technical portion of a diagnostic test being sent to another country, but Medicare cannot pay for an interpretation provided outside the United States.

Medicare Q & A: If Medicare decides documentation from a former member of a practice doesn't support the levels that were billed, who will be responsible for paying Medicare back?

September 15, 2009
By:Don Self

If payment to a former member of a practice was reassigned to the group, and the documentation is found wanting, it will be up to the group practice to pay Medicare any recoupment and/or fines.

Medicare Q & A: In regards to a collection issue, is there a Medicare requirement that statements be sent to patients at certain intervals?

September 15, 2009
By:Don Self

There is no requirement by Medicare that you send a final notice or certified letter before you turn a patient over to a collection agency.

Medicare Q & A: At a recent seminar I heard that Medicare no longer allows physician assistants or nurse practitioners to perform consultations. Is that correct?

September 15, 2009
By:Don Self

Physician assistants and nurse practitioners can bill consultations to Medicare on new or established patients. Use the outpatient consultation codes in the office (99241-99245) or inpatient consult codes 99251-99255.