Many times our provider will see a patient that has been in urinary retention and do an E/M and then a voiding trial on the same day. They will prescribe a medication (such as Bactrim) to cover for the Voiding Trial. For the E/M, they have enough dictation for a 99214 because of prescribing the Bactrim, but would I include the Bactrim in the procedure instead of in the E/M part of the visit?
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Tag Archives: Voiding
Bladder Scans and Voiding Trials
Does anyone charge for bladder scans or for voiding trials when a patient is in a post op period? I was told that you couldn’t charge either, but thought I would ask what other offices are doing?
Corrected Claim VS Voiding claim: What would you do??
Hoping to get some feedback on an issue I am having with submitting corrected claims.
The scenario:
Physician office files a claim to Medicaid MMA and after claim is submitted a commercial insurance is discovered that the patient had not reported to either Medicaid or our office. Our office reports the commercial insurance to the MMA and files a claim to the commercial insurance.
In the meantime the MMA pays claims and then the commercial insurance pays claim, now the claim is overpaid.
I have been resubmitting the claim to the MMA as a corrected claim with a copy of the EOB from the commercial insurance. My thought is that the MMA will see the commercial insurance payment and reprocess their claim and ask for a refund of the overpayment.
What is routinely happening is the MMAs are denying as a duplicate when the claim is clearly marked with a submission code 7 with the claim # references.
My other option would be to submit a voided claim but I feel this is not correct as the service was provided so I do not feel the void would be appropriate.
This is a huge problem for our office. Patients routinely do not disclose their commercial insurance as they do not want to pay ANYTHING and think that if they dont disclose they commercial insurance will not be eventually discovered.
How would you handle the overpayments on the claim?