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Originally Posted by shcisamax
For what reason would Medicare deny a claim? If a doctor who takes medicare sees a patient and writes a prescription, or recommends an operation, how can Medicare deny it?
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Medicare is extremely picky about how a claim is submitted. There are many similar codes for the same procedure. If one code was approved and if the code submitted is off by one number...it's denied. I've seen procedures or visits denied because of a period in the wrong place. Medicare as a payor is very difficult to deal with. And as another poster said....if medicare denies it, the secondary automatically denies.....then it starts all over....resubmit....repeat. And, yes, this happens even when electronically submitted.