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I’m running across some claims where the patient’s medical group (HMO plan) is forwarding on the TDAP vaccine portion of a claim to the members health plan; EOB states "not IPA responsibility, claim forwarded." Then I will receive an EOB from the health plan stating "medical group for these services." Not sure how to go about resolving these and would greatly appreciate some feedback/advice.
Thanks!!
1. Does Medicare pay for the Tdap or not? I was always under the understanding that Medicare does not pay for the Tdap. Ever. Just a TD if there is a injury. Then I came across this:
https://www.cms.gov/medicare-coverag…=AggAAAQBAAAA&
I thought the Tdap was not a Medicare benefit. I am so freaked out. LOL. So it can be billed? Any special way? Modifier?
2. When a (Medicare) patient has a Hep B vaccine due to a lab test showing no immunity does it need to be bill in a certain way? Special modifier?
Thank you so much!
1. Does Medicare pay for the Tdap or not? I was always under the understanding that Medicare does not pay for the Tdap. Ever. Just a TD if there is a injury. Then I came across this:
https://www.cms.gov/medicare-coverag…=AggAAAQBAAAA&
I thought the Tdap was not a Medicare benefit. I am so freaked out. LOL. So it can be billed? Any special way? Modifier?
2. When a (Medicare) patient has a Hep B vaccine due to a lab test showing no immunity does it need to be bill in a certain way? Special modifier?
Thank you so much!