Wiki Medicare EM/Consult Duplication

joy7ann

Networker
Messages
31
Location
Franklin, TN
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If a patient presents to our Adult Daycare and they have their own primary care doc can we bill Medicare for an H&P with our medical director as a condition of admission? I am trying to make the case that this is redundant and could be fraudulent. Please help.
I called CMS and they said as long as their is medical necessity they will pay but they would not define what they consider medically necessary...:confused:
 
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