(Medicare Benefit Policy Manual)

Following is an example of services received subsequent to a non- covered inpatient stay:   After a beneficiary has been discharged from the hospital stay in which the beneficiary received non -covered serv ices, medical and hospital services required to treat a condition or complication that arises as a result of the prior non -covered services may be covered when they are reasonable and necessary in all other respects.  Thus, coverage could be provided for s ubsequent inpatient stays or outpatient treatment ordinarily covered by Medicare, even if the need for treatment arose because of a previous non -covered procedure.  Some examples of services that may be found to be covered under this policy are the reversal of intestinal bypass surgery for obesity, complications from cosmetic surgery, removal of a non- covered bladder stimulator, or treatment of any infection at the surgical site of a non- covered transplant that occurred following discharge from the hospital .  However, any subsequent services that could be expected to have been incorporated into a global fee are not covered.  Thus, where a patient undergoes cosmetic surgery and the treatment regimen calls for a series of postoperative visits to the surgeon fo r evaluating the patient's progress, these visits are not covered.   Transmittals Issued for this Chapter  Rev #  Issue Date  Subject  Impl Date  CR#  R198BP  11/06/2014 Medicare Coverage of Items and Services in Category A and B Investigational Device Exemption (IDE) Studies  01/05/2015  8921 R189BP  06/27/2014 Invalidation of National Coverage Determination 140.3 -  Transsexual Surgery  06/29/2014  8825 R186BP  04/16/2014 Clarification to Pub. 100- 02, Medicare Ben efit Policy Manual Regarding Antigens and Deletion of Section 13.14 from Chapter 13 of Pub. 100- 08, Medicare Program Integrity Manual  05/12/2014  8665 R184BP  04/11/2014 Clarification to Pub. 100- 02, Medicare Benefit Policy Manual Regarding Antigens and Deletion of Section 13.14 from Chapter 13 of Pub. 100- 08, Medicare Program Integrity Manual  Rescinded and replaced by Transmittal 186  05/12/2014  8665 R170BP  05/10/2013 Updates to Medicare Coverage of Hepatitis B Vaccine and its Administration and Medicare Coverage of the Annual Wellness Visit (AWV) Prov iding Personalized Prevention Plan Services (PPPS)  06/10/2013  8275 R122BP  04/09/2010 Claims Submitted for Items or Services Furnished to Medicare Beneficiaries in State or Local Custody Under a Penal Authority and Examples of Application of Government Entity Exclusion.  This CR rescinds and fully replaces CR 6544. 07/09/2010  6880 R110BP  09/04/2009 Claims Submitted f or Items or Services Furnished to Medicare Beneficiaries in State or Local Custody Under a Penal Authority and Examples of Application of Government Entity Exclusion  Rescinded and replaced by CR 6880, Transmittal 122 12/07/2009  6544 R102BP  02/12/2009 Shipboard Services Billed to the Carrier and Services Not Provided Within the United States  03/13/2009  6327 R95BP  10/03/2008 Shipboard Services Billed to the Carrier and Services Not Provided Within the United States  Rescinded and replaced by CR 6327, Transmittal 102  01/05/2009  6217 R66BP  02/23/2007 Services Not Provided Within United States  04/02/2007  5427 R39BP  11/10/2005 Auditory Osseointegr ated and Auditory Brainstem Devices  12/12/2005  4038 R38BP  08/19/2005 Services Not Provided Within United States  11/17/2005  3781 R1BP  10/01/2003 Introduction to the Benefit Policy Manual  N/A N/A Back to Top of Chapter