Wiki WPS consolidated billing

[swright929]

I work at a GI practice in Southern Indiana. We have an in house path lab. According to WPS they are paying our Medicare claims - global billing for the TC and PC components and then recouping due to "consolidated billing". Is anyone else in IN dealing with this and if so what are you doing to get payment? If you read up on it you can bill the professional component according to the date the pathologist does the report but then if you bill the TC on the actual date of the procedure that can turn into a nightmare with using different dos. Any advice or suggestions would be appreciated. Thanks Sammye

 

[bbooks]

I work for a pathology group. We also received this new mandate from WPS. We can no longer bill a globally for a single DOS. We are now split billing our Medicare cases, including the DOS for the TC (the date the specimen was obtained) and the DOS for the professional component (the date the case was read out by the pathologist). We have not yet submitted these cases to Medicare with this split billing, so we are still waiting to see if we will have any new problems with getting claims paid. From what we were told by our lawyer, CMS has no authority to override what the individual MAC require. Some MACs have chosen to still allow global billing.