Wiki Urgent care billing

[paula f3]

Please help as I am very new to billing urgent care. I coded the visit with E/M code and patient was also dispensed crutches( E0114). Patient is Medicare, would the crutches not be billed to DME?
The biller is stating that she bills the visit with a modifier 25. I don't agree.

Input appreciated.

Thank you
Paula

 

[mitchellde]

You are correct, the crutches would be billed to DME. You must have a DME supplier number for Medicare. If there was no other procedure rendered, then you do not need the 25 modifier.

 

[ehanna]

Please help as I am very new to billing urgent care. I coded the visit with E/M code and patient was also dispensed crutches( E0114). Patient is Medicare, would the crutches not be billed to DME?
The biller is stating that she bills the visit with a modifier 25. I don't agree.

Input appreciated.

Thank you
Paula

However if you verify your facility has a DME certificate then they can be dispensed and billed.

Otherwise a prescription should be written and the patient go to DME supply company.

Hope this helps