Occurrence code 25 with first date of service showing is not a medicare qualified service. Make sure you have an ABN on file.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Friday, November 08, 2019 9:37 AM
To: billers@list.mnhomecare.org
Subject: Healthpartners inspire
Good morning,
We have a patient on Healthpartners inspire authorized for nursing services T1030 code. For some reason our claim generated the incorrect code G0299 and claim denied stating Medicare is the primary payer. I have worked with our software
company to fix the code to T1030. However, if I bill it with that code to healthpartners will they still deny it for Medicare being the primary payer? Patient does not have a skilled need and is not homebound. The nurse navigator at healthpartners did say
they do not require patient to be meeting Medicare criteria. Do you usually bill Medicare first for a denial? Or would you have a patient sign ABN and use the 25 occurrence code to bypass billing Medicare? Any input would be greatly appreciated. I am not familiar
with this policy. Thank you!
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
Confidentiality Notice: This document and information and other materials shall be protected by the peer review privilege statues and regulations. Please keep it strictly confidential, and do not disclose to anyone except to other
individuals involved in the quality and peer review process. Unauthorized duplication or distribution is strictly prohibited. Records, data and knowledge, including minutes collected for any by individuals or committees, are confidential, not public record
and are not available for court subpoena in accordance with Minnesota MSA 145.62-145.64.
-----------------------------------------------------------------------
Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
privileged and confidential information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy
all copies of the original message.