Medicare Secondary Payer Manual (Pub. 100-05), Ch. 5 § 30.4.1

Patient Receives Concurrent Services Which Are Not Work-Related

Last amended: 2022Year: 2022Length: 118 wordsOfficial source
30.4.1 - Patient Receives Concurrent Services Which Are Not Work-Related (Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22) Sometimes an individual receives services for a condition that is not work-related from the same provider or physician/supplier who is furnishing services for a work-related condition. The diagnosis may indicate a service for a preexisting condition or the provider or physician/supplier may submit a separate bill for services indicating that the service is for a non-work-related condition. Where it is clear that services for a non-work-related condition were rendered, the A/B MAC and the DME MAC does not delay payment for such services even though payment for the work-related services is being denied or delayed pending development under the WC exclusion.
Medicare Secondary Payer Manual (Pub. 100-05), Ch. 5 § 30.4.1: Patient Receives Concurrent Services Which Are Not Work-Related | Justis AI