Wiki Billing Medicare Secondary for Screening Colonoscopy

[cedwards]

We are billing the patient's primary insurance 45378 with V76.51 for a screening colonoscopy.

The primary made payment but patient still has a coinsurance which we are billing to Medicare.

Medicare is secondary and denied the claim These are non-covered services because this is not deemed a `medical necessity' by the payer.

How would you handle this?

Are you billing all screenings with G0121 or G0105 to all payers?

 

[Peke]

We have to modify our charge to G code to Medicare as 2ndary. Not all primary insurance carrier recognize the G codes in contracts.

 

[bridgettemartin]

We also have to change the codes once the primary has paid.