Wiki Medicare denials-If a service is

[nc_coder]

If a service is denied with code CO-B15, can I bill the patient if they signed an ABN?

 

[Peter Davidyock]

Give a frame of reference please.

 

[nc_coder]

reference

Give a frame of reference please.

I have the reference posted in another thread, but no one was replying.

Our physician marks a prostate exam with an AWV. I code this as G0438/G0439 and
G0102. The physician also does a separate E/M for other issues. The G0102 is denied with code CO-B15 as bundled with the E/M. Am I allowed to bill the patient if we have an ABN for the prostate exam?

 

[nc_coder]

Still don't have an answer here.

 

[mitchellde]

the prostate exam is a covered service by Medicare unless your timing is off. So unless the timing is off then I say no you cannot bill the patient. Why was the office visit billed? also what dx code did you use for this service? what dx codes were billed on the claim for all services and how were they linked

 

[Meganlparsons]

Prostate exam issue

I don't do your billing but I'm one heck of a researcher...review the attached MLN Matters and another article...

http://www.supercoder.com/coding-ne...creening-with-appropriate-hcpcs-codes-article