tci Part B Insider - 2007 Issue 33

REIMBURSEMENT: Don't Treat A Second-Hand Problem Like A New Development

Don't bill Medicare for routine pre-operative chest X-rayA problem may be new to your doctor, but that doesn't make it -new- for payment purposes, warns Part B carrier Palmetto GBA.A -new problem- is one that someone has identified but nobody has diagnosed, Palmetto says in a new Frequently Asked Questions (FAQ) answer on its Web site. A -new problem- may require an additional work-up to diagnose properly. But if a patient shows up in your office with a problem that someone else has already diagnosed, that's not a -new problem.- You should score that visit the same...

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