bethb
Guru
We bill Medicare Part B / professional services. Our physician is a dermatologist. We billed Medicare Part B for a laboratory service, 88305, global billing, as our physician performs and interprets the test in his office and has the appropriate CLIA certification.
Medicare Part B denied payment for 88305 stating it is a non-covered charge; Home Health Consolidated billing and payment applies. We are familiar with SNF consolidated billing, and know that the technical component of the test would not be paid under Part B if the patient was under a covered Medicare Part A stay in a Skilled Nursing Home. BUT, I cannot find any rules governing consolidated billing regarding beneficiaries receiving covered Home Health services, other than consolidation applies to the following:
Skilled Nursing care
Home Health aide services
PT, OT, SLP
Medical Social Services
Routine and nonroutine medical supplies
Medical services provided by an intern or resident-in-training..
Care for home bound patients..
None of those apply to our situation. Am I missing something regarding physician services / professional services / Part B billing and Home Health Consolidated Billing? Is there anyone who can shed some light on this? Anyone else come across the same denial for their Part B billing?
Thank you all.
Beth
Medicare Part B denied payment for 88305 stating it is a non-covered charge; Home Health Consolidated billing and payment applies. We are familiar with SNF consolidated billing, and know that the technical component of the test would not be paid under Part B if the patient was under a covered Medicare Part A stay in a Skilled Nursing Home. BUT, I cannot find any rules governing consolidated billing regarding beneficiaries receiving covered Home Health services, other than consolidation applies to the following:
Skilled Nursing care
Home Health aide services
PT, OT, SLP
Medical Social Services
Routine and nonroutine medical supplies
Medical services provided by an intern or resident-in-training..
Care for home bound patients..
None of those apply to our situation. Am I missing something regarding physician services / professional services / Part B billing and Home Health Consolidated Billing? Is there anyone who can shed some light on this? Anyone else come across the same denial for their Part B billing?
Thank you all.
Beth