Forum - Questions & Answers

May 6th, 2012 - ravip3366 19 

FQHC Billing

i'm working for FQHC.
We are billing all services 'incident to' physician services to Medicare, but getting RTPd reason codes like 32402, 32404.
what revenue code can be used for lab services to bill Medicare.

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May 7th, 2012 - Shannan 28 

re: FQHC Billing

You dont use a modifier on the 36415 but the lab has to bill for the actual labs. Medicare will not reimburse you for the labs. Medicare and Medicaid have to be billed by the lab. In an FQHC you bill private pay patients and private insurance only for venipuncture and labs using a modifier 90 on all the labs.

Hope this helps.

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May 7th, 2012 - ravip3366 19 

re: FQHC Billing


Yes, Medicare will not pay labs. But we are billing so as we need denial from Medicare as non-covered services to bill secondary.

But we are getting total rejection of the claim (incl. office visit); since we are using rev.code 0521 for labs also.

My question is what revenue code should be used for laboratory services while billing FQHC claims to Medicare.

Thanks in advance

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