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Injection biiled to medicaid

SuperCoder Posted Fri 23rd of March, 2012 17:35:15 PM

I need to know what is it I have to do to get the Injection billed to Medicaid. I try to bill the same way I bill all the other ins, but it is not going through to medicaid. Like J1100 or J3420. Is there anyhting I need to add to the medicaid claims for them to get paid

SuperCoder Answered Fri 23rd of March, 2012 18:14:30 PM

Medicaid is governed by state and Medicaid policies differ from state to state.
Typically a physician can't charge patient (whole amount or part amount as co-pay) if patient is eligible for medicaid payment (have an active medicaid insurance); however this is not applicable to every state.
For an example - NY state medicaid policy for the same is...
"The provider must not reduce the amount charged on a Medicaid claim by the co-payment that is collected from a Medicaid recipient. Each claim that requires a co-payment will have the co-payment automatically deducted from the final payment when the claim is approved for payment. "

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