OK, I was able to coverse the patient on the matter. This is not workers' comp per say, but a 'court settlement', in which the patient got diab. b/c of heart medication so all his diabetese claims need to go to this priv. ins. and all non-diab. claims go to Medicare. Tell me if I am right on this now:

Since Medicare has paid for all diab. and non-diab visits, I think Medicare should be refunded the money for all diabetes (but not non-diab) visits and I should NOT adjust according to priv. ins. on diabetese and according to Medicare on non-diab. claims????