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does medicare cover a PET scan CT scans done & were inconclusive .s Additional testing is required to obtain a diagnosis ?
Yes Medicare does cover PET scans but only under the following 5 related applications: 1.Solitary Pulmonary Nodule 2.Staging of lung cancer. 3. Staging of Lymphoma. 4. Staging of Melanoma and detection of recurrence. 5. Recurrent colorectal cancer. In your case that a diagnosis is still inconclusive Medicare will not cover the test.
What else can I help you with?
What is the number required by centers for medicare and medicaid on claims for clinical diagnosis services is called?
National provider identifier
How many diagnosis code pointers can be assigned to a procedure code?
You may list up to 4 in the provided spaces on the CMS 1500 claim form. However, according to Medicare Change Request 5441, which was implemented on July 2, 2007, all Medicare carriers (Fiscal Intermediaries) are REQUIRED to accept up to 8 diagnosis codes.
Can a Medicare participating hospital refuse a needed surgery on a Medicare patient?
Providers are not required to take Medicare (or Medicaid) patients. Hospitals are required to provide emergency care regardless of ability to pay.
What is the penalty for doctors that don't accept Medicare?
There is no penalty; providers are not required to accept Medicare or Medicaid.
What are the Medicare laws regarding Pain Clinics?
Contact Medicare or the clinic to see if they accept a Medicare payment. You may be required to pay the difference between the actual cost and the payment from Medicare.
Are you required to pay into Medicare forever?
In general, Medicare is deducted from any earned income, regardless of the age or Social Security/Medicare eligibility of the wage earner.
If you qualify for medicaid will you get back money taken out of medicare before qualification?
You are not required to pay back Medicaid or Medicare.
HOW DO YOU CODE 81001 TO MEDICARE?
To code 81001 for Medicare, you would use the appropriate billing process for laboratory services, as 81001 refers to a urinalysis test. Ensure that the documentation supports the medical necessity of the test and include the patient's information, diagnosis codes, and any other required details. Submit the claim electronically or via paper form, following Medicare's specific guidelines for laboratory services. Always verify that the procedure is covered under the patient's Medicare plan.
Is a CMN required when billing medicare for durable medical equipment?
true
When submitting a claim to Medicare the name of the insured is required not situational?
true
Do I have to get Medicare Part B if I have Tricare from the Military?
If you have TRICARE and are eligible for Medicare, you are not required to enroll in Medicare Part B; however, it is often beneficial to do so. TRICARE typically serves as secondary coverage to Medicare, meaning that having both can help cover additional costs. If you choose to delay Part B and later decide to enroll, you may face a late enrollment penalty. It's advisable to review your specific situation and consult with a benefits advisor to understand the best options for your healthcare needs.
Are there private contracting providers who do not participate with medicare or medicaid payments?
Providers are not required to participate in either the Medicare or Medicaid program. In addition, providers are required to tell you when you present your Medicare or Medicaid cards that they do not accept the programs (generally this is on the paperwork where they ask for the insurance information). If they render treatment and you have presented your id cards prior to the visit (and they did not otherwise advise you or have you sign something that they don't participate) then contact Medicare at 1-800-Medicare to report the provider.
