[blyons]

We have pts that want to buy a second regulator for convenience.
It can't be processed with a NU modifier (even if we obtain an ABN and use a NUGA modifier configuration). Is anyone billing this situation thru Medicare?

[whozleft]

We all know the Medicare requires medical necessity to be proven. Having said that and reading your post concerning the patient's wanting the regulator for "convenience". I would simply say that I would offer them a good price and let them know that it would be a cash sale item. Why even attempt to bill them to Medicare?

Times have changed and to attempt billing for an item that you pretty much know won't be covered is just adding to your bottom line expenses. It costs you money to have your billing folks bill an item.

[HEATHER]

Just have them sign an ABN that states a 2nd regulator is not a covered benefit. Have patient check box that says "we will pay - we do not want Medicare billed." Then you are covered and don't have to bill it at all.