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Click here for more sample CPC practice exam questions and answers with full rationale

SNF and Part B billing for Professional services

I am returning to the billing world after three years in other areas of the medical world. The other day I spoke with Medicare RE: Our office performed a DVT rule out for a SNF patient. Initially, Medicare paid and then took it back. Then the bill was submitted to the SNF, but the denied it as it’s a professional service and as far as we know we do not have a contract with this SNF. So I contacted Medicare to ask how may I bill this out? I was directed to 2018 Part B MAC Update as was also told to place a 26 modifier on 93971. We did get paid, but I was told by another biller that this was very wrong I should have never done this as the SNF needs to pay. I could use any additional guidance on this as the other biller is not willing to help me understand what I did that was so wrong when Medicare told me to do this. I know SNF is Part A and our services are Part B and with out a contract agreement, the SNF is not required to pay (I worked in contracts for two years). Any help would be appreciated!:confused:

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