Check this list to see if any problem spots look familiar
If Medicare sometimes denies your claims on the grounds that you sent a duplicate claim or because you billed for bundled services, you're not alone. Here's a list of Medicare's top-10 denials, compiled by averaging data from nine different Medicare carriers:
• duplicate claim submissions
• bundled services
• individual provider number and/or group number missing from 24k or 33 of the CMS-1500 form
• the payer does not deem the diagnosis linked to the procedure a "medical necessity" for that service
• Medicare is the secondary payer but is being billed as primary
• noncovered services
• patient is not a Medicare beneficiary
• UPIN and name of ordering or referring physician is missing or invalid
• incorrect modifier usage
• procedure is a "screening" service and therefore not eligible for payment.
