My office is currently confused on the DOS we should be billing for professional charges per the attached article SE17023 from MLN matters. We are confused because we are interpreting the article in two different ways. I see that it states "reimbursement for Medicare Part B services" so to me it is only to Medicare Part B claims and no other claims. My coworker states that it would be any insurance that also follows Medicare guidelines (commercial and Medicaid). I just need some insight if this is accurate thinking.
The next issue is what date do we use. Lets say a hypothetical situation of the following: patient has gallbladder removed on 05/21/2025 and pathologist reviews and interprets specimen on 05/27/2025. what date do we bill for the professional service. I know that the technical service would be billed 05/21/2025 but do we bill professional as 05/21 or 05/27??
Noridian (our Medicare jurisdiction) does not stipulate we need to use the date of interpretation, it is just the attached article.
The next issue is what date do we use. Lets say a hypothetical situation of the following: patient has gallbladder removed on 05/21/2025 and pathologist reviews and interprets specimen on 05/27/2025. what date do we bill for the professional service. I know that the technical service would be billed 05/21/2025 but do we bill professional as 05/21 or 05/27??
Noridian (our Medicare jurisdiction) does not stipulate we need to use the date of interpretation, it is just the attached article.
