Medicare Billing Guidelines | Medicare Parts A, B, C and D

Medicare Billing Guidelines | Medicare Parts A, B, C and D

"From the September 2014 Full Webinar Transcript": Free for all! Get CEU's!"

Q: What services are covered under the various Parts of Medicare? Got any tips on how to remember this?

A: Now you do need to memorize this. I think that it’s important for us to be upfront and tell you, “No, you don’t have to memorize this. You’ve got resources and you can look them up.” And yet, there are certain things that you probably should just go ahead and memorize and this is one of them.

I found this lovely couple to put on my slides…

Laureen: I’m going to say too, this information shows up on several of the exams. It’s on the new inpatient ones, it’s on outpatient, and I think there’s a little bit on the CPC exam.

Alicia: Yeah, there is on the CPC exam.

Laureen: And it’s on the billing credentials so that’s four credentials, right off the top of my head, so this is definitely worth memorizing.

Alicia: Well, I’ll mention after this slide so we don’t mess it up for Boyd when he’s trying to do recordings and stuff.

Medicare coverage is based on 3 main factors: federal and state laws, national coverage decisions made by Medicare about whether something is covered, and local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

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Medicare Billing Guidelines | Medicare Parts A, B, C and D

4 thoughts on “Medicare Billing Guidelines | Medicare Parts A, B, C and D

  1. Really good overview. I have an elderly parent who is disabled and confined to his bed. Where does coverage for hygiene care such as bathing fall within the Medicare guidelines?

    • +mpa gallery I used to be an Occupational Therapist and we were able to teach ADL skills (Activities of Daily Living) and charged for that accordingly. You might want to ask your home health agency if they can have an OT come in to teach some independent ADL skills. But if your parent simply isn’t able to be independent your talking about nursing aide care which again a home health agency should be able to help you with. –Laureen

    • +MedicalCodingCert Thanks for the suggestion. We called Visiting Angels and similar personal care companies but they said the situation is too complex and to call a skilled nursing agency. But no one seems to know if bathing and other hygiene care is covered by Medicare or other government agency. Its very difficult to find information on what is and what is not covered, how much, and for how long.

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