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An Established Patient Is Seen with a Participating Provider of Medicare

Question 56

Multiple Choice

An established patient is seen with a participating provider of Medicare for an office visit on August 13th for knee pain, gets a joint injection, and the electronic claim is sent on September 1st of the following year. The claim is sent out with an office visit code of 99213 and a diagnosis code of M25.569. No payment is sent back. What is the most probable reason why it was sent with no payment?


A) incorrect codes
B) it was not sent on a paper form
C) it was a non-participating provider
D) claim was not sent in a timely fashion

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