CPT code Q4101, Q4106, Q4121, Q4132, q9363

Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity The provisions of this LCD apply to payment for bioengineered skin substitutes (BSS) for chronic ulcers of the lower extremities secondary to diabetes and venous stasis. This LCD does not...

Surgery Modifier code list

Modifiers Pertaining to Surgery or Services within the Global Period Modifiers assure that the carrier will give  consideration to the special circumstances that may affect payment. Omitting modifiers may result in payment denials. If a review is requested on a...

Therapy payment caps and exception process

The Financial Limitation Legislation A. Legislation on Limitations The dollar amount of the limitations (caps) on outpatient therapy services is established by statute. The updated amount of the caps is released annually via Recurring Update Notifications and posted...