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US · guidance

CMS Pub. 100-05, ch. 5, § 30.4.1

Patient Receives Concurrent Services Which Are Not Work-Related

activein force · 2026-08-25 – presentas-observed

Sometimes an individual receives services for a condition that is not work-related from the same

provider or physician/supplier who is furnishing services for a work-related condition. The diagnosis

may indicate a service for a preexisting condition or the provider or physician/supplier may submit a

separate bill for services indicating that the service is for a non-work-related condition. Where it is

clear that services for a non-work-related condition were rendered, the A/B MAC and the DME MAC

does not delay payment for such services even though payment for the work-related services is being

denied or delayed pending development under the WC exclusion.

History

(Rev. 11550; Issued: 08 -12-22; Effective: 10 -13-22; Implementation:10 -13-22)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7c7fcd2217bb4a5c4bcef07b9709b13cf5625c6434a4e516f4eea0256db8bb85
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