Wiki need help on coding please

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jbhuju

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hello everyone,
as being new coder in FQCH i need help. we were been billing covid vaccine to medicare but someone told us as being FQHC we can not bill medicare not even admin code. so we are adjusting off the admin code instead of billing it out. please some one could help me how this going to work? as being FQHC how do we need to bill medicare and what revenue code should we use? i live in arizona. thank you in advance :)
 
jbhuju said:
hello everyone,
as being new coder in FQCH i need help. we were been billing covid vaccine to medicare but someone told us as being FQHC we can not bill medicare not even admin code. so we are adjusting off the admin code instead of billing it out. please some one could help me how this going to work? as being FQHC how do we need to bill medicare and what revenue code should we use? i live in arizona. thank you in advance :)
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I work at an FQHC also. The admin charge goes on the cost report. You don't bill it to Medicare. They are handling admin charges for Med Advantage patients in this manner also - you do not bill the Med Advantage plan, it goes on the cost report. If you are billing an office visit and a covid vax to Medicare on the same claim you treat it the same as a flu vaccine - add condition code A6 in box 24 of the UB - this lets Medicare know they need to pay you on the cost report.
 
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hperry10 said:
I work at an FQHC also. The admin charge goes on the cost report. You don't bill it to Medicare. They are handling admin charges for Med Advantage patients in this manner also - you do not bill the Med Advantage plan, it goes on the cost report. If you are billing an office visit and a covid vax to Medicare on the same claim you treat it the same as a flu vaccine - add condition code A6 in box 24 of the UB - this lets Medicare know they need to pay you on the cost report.
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thank you for reply
but we are not doing office viist, it is just covid vaccine. so we we do not bill medicare how they going to pay us on cost report do we need to send any reports or do we bill admin fee with modifier to let medicare know we are not billing patient this is just for record so we can get on cost report, i am little confused. please help.
thank you :)
 
How do you handle a flu shot without an office visit? Flu shots go on the cost report as well. You should follow the same process. In my clinic we adjust those charges using specific internal adjustment codes, at the end of the year our finance department uses those adjustment codes to generate the cost report and sends it off to Medicare for reimbursement.
 
hperry10 said:
How do you handle a flu shot without an office visit? Flu shots go on the cost report as well. You should follow the same process. In my clinic we adjust those charges using specific internal adjustment codes, at the end of the year our finance department uses those adjustment codes to generate the cost report and sends it off to Medicare for reimbursement.
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ok now i got it. so finance dept will send at the end of the year to medicare then . that is the part that i was confused. so i am good now. thank you so much for help. :)
 
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