Wiki Q4316

[jmsnopkowski]

Has anyone billed this code Q4316 to Medicare and received payment? If so, what was the reimbursement rate?

 

[SDargaj]

It will depend on several factors such as facility vs. non facility...what MAC you're in....etc.
This all will play a part in reimbursement.

 

[jmsnopkowski]

The services were rendered at home (Nursing home). I used POS 12. Medicare has denied for missing Invoice. I added invoice to claim and rebilled, and it still denied. I spoke with Medicare and they said I have to add something in the loops and segments, fill out a form fax it with the Invoice that shows what the provider paid, get the claim # then bill the claim after I have faxed the form.
I have never had to go through these hoops for a Graft before. The graft company is fairly new (December 24), so I am wondering if they didn't register with Medicare correctly??
Any advice would be greatly appreciated

 

[snorman3]

Did you end up figuring this out and getting reimbursed? I'm curious as we just started using this code and Medicare is taking quite a long time to even process the claim.