Marla Posted Fri 11th of November, 2016 11:44:23 AM
If we bill a patient calls and wants their hearing tested, can we bill a commercial insurance company if they are not referred by a physician for that test?
SuperCoder Answered Mon 14th of November, 2016 02:41:09 AM
Greetings from SuperCoder.com!
As per CMS, “If a beneficiary undergoes diagnostic testing performed by an audiologist without a physician order, the tests are not covered even if the audiologist discovers a pathologic condition.”
Different payers may have different coverage guidelines, so for particular commercial insurance, you should read their coverage guidelines if present online or contact them and ask their policy for these tests.
Please feel free to write if you have any further questions.