Load a worked claim Clear Each one loads into the claim below and runs. Change the place of service, the program or the percent of Medicare and check it again — the scenario is a starting point, not a fixed demo.
Edits — the line is stopped
A 59 that won't work Units over the cap Necessity unproven Hospital-only, billed in a clinic A second surgeon who can't be paid Bilateral on a code that isn't ED visit billed from an office Nothing wrong with it Wellness visit, then a problem the same day Preventive physical billed to Medicare Annual wellness visit — what Medicare covers Flu shot, given and administered
Reductions — the line is paid, and paid less
MSR · second surgery at 50% Therapy MPPR · PE cut on the second unit Imaging MPPR · technical component Endoscopy · base value subtracted