Wiki Tetanus Injection

[KN]

For a Preventative tetanus injection for a Medicare member, is it appropriate to bill the member for this service since Medicare does not cover preventative tetanus injections? thank you

 

[mitchellde]

You probably need a signed ABN for the tetanus injection before the could patient could be billed. If it is preventive then the patient would be able to refuse the injection since it would be their responsibility to pay. If this was not explained up front, and the ABN signed, and then billed with the appropriate modifier to show ABN obtained , you would not be able to bill the patient.

 

[thomas7331]

I agree, you should not bill a member for this without having notified them and obtained their agreement first. I'd add too that the member's Medicare Part D prescription drug benefit may cover this service, in which case, the member may wish to obtain the service from a provider who can submit the claim to their pharmacy plan in order to have it paid.