Podiatrist and Medicare Claim Billing with 837 claims

Medicare is identifying that Podiatrists are having issues submitting clean claims using the ANSI 837 file format. If you are billing for a podiatrist that performs routine foot care services, and you are identifying lack of payment on Medicare claims please follow these suggestions:

1. Enter "Date Last Seen (DLS)" in Loop 2300 with the DTP segment and 304 Qualifier
- DLS is the most current date the patient was seen by the attending physician for the services rendered and is required on the claim

Example: DTP*304*D8*20080922~

- Date/Time Qualifier 304 must be included on the claim (used to convey dates associated with the information contained in the corresponding EB Loop)

2. Enter supervising/attending NPI in Loop 2310E, NM109 segment with a DQ indicator. XX will be in segment NM108.
- Supervising Providers Name must be submitted on the claim
- Entity Identifier Code must be DQ
- Supervising Provider UPIN must be submitted

Another note: If you received payment on claims submitted incorrectly (i.e. not billing this information in this format) Medicare is requesting that you refund all payments made and have the claims reprocessed under the correct format.

Learn more about Electronic Medical Billing and Coding at this site medical billings and health insurance claims

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