Y was not covered
Odds are that your "provider" didn't know that either.
It's been over 3 years since I stopped billing directly, but I remember many examples. Here is one. Running a predominantly geriatric practice, I had to become quite good at treating stasis dermatitis ulcers, diabetic leg sores and wounds, and other such things. Many times those things require time and patience, they need to be cleaned, sometimes debrided, they need antibiotics... The best bandage is the so called Unna boot - simply a roll of gauze soaked in zinc oxide. It works quite well. Not very sophisticated it terms of Internal medicine, but... it works.
Anyway, one day we started getting denials - Medicare would only pay for the visit, but not for treating the wound. That was their new policy, retroactive for a few months. I still continued doing exactly the same thing, for free. The only difference was that I would ask those patients who could afford it to go to a surgical supply store and buy supplies.
Presently, as a "hospitalist", I often treat the same problems, using the same means - except that the cost to Medicare is several thousand dollars a day. Instead of training docs to do this, and encouraging it, those a-holes cut it. Government healthcare wisdom in action. |
