by Medical Billing | Jun 16, 2018 | CPT modifiers
Corrections in the Medical Record If the original entry in the medical record is incomplete, contracting providers shall follow the guidelines below for making a correction, addendum, or amendment. Signature requirements as defined above apply to all corrections in...
by Medical Billing | May 18, 2018 | CPT modifiers
UTILIZATION REVIEW AND MEDICAL NECESSITY The contracting provider agreement requires providers to cooperate in utilization review and medical necessity determinations. Utilization review is the process of determining the appropriateness of services rendered to and...
by Medical Billing | Nov 13, 2017 | CPT modifiers
RESPITE BENEFIT Respite services provide limited and temporary relief for families caring for beneficiaries with complex health care needs when the care needs require nursing services in lieu of the trained caregivers. Services are provided in the family home by...
by Medical Billing | Oct 10, 2017 | CPT modifiers
CPT/HCPCS Codes J3490* Testosterone pellets (Testopel®) 11980* Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin) * Providers must bill HCPCS code J3490 and CPT code 11980 on the same claim. If HCPCS code...
by Medical Billing | Oct 6, 2017 | CPT modifiers
INTERMITTENT NURSING VISITS/AIDE VISITS/THERAPIES Each visit must be reported on a separate claim line: Medicaid follows Medicare policy on the requirement that each home health agency visit (e.g., nursing, therapy) must be billed on an individual line. This policy...
by Medical Billing | Sep 11, 2017 | CPT modifiers
N10 Acute tubulo-interstitial nephritis Includes: acute infectious interstitial nephritis acute pyelitis acute pyelonephritis acute tubular necrosis hemoglobin nephrosis myoglobin nephrosis Use additional code (B95-B97), to identify infectious agent. N11 Chronic...
by Medical Billing | Jul 28, 2017 | CPT modifiers
The most common codes that will be used in Primary Care are related to conjunctivitis. The two categories related to conjunctivitis are found in the table below, but the most commonly used codes are: • H10.0 Mucopurulent conjunctivitis • H10.01- Acute follicular...
by Medical Billing | Jun 20, 2017 | CPT modifiers
CPT Code Description 90801 Interview evaluation 90804 Individual therapy 20 – 30 min 90806 Psychotherapy 90807 Psychotherapy with medical evaluation and management 90862 Pharmacologic management New and Deleted Procedure Codes The following psychiatric services...
by Medical Billing | Jun 12, 2017 | CPT modifiers
CPT Code Description 19328 Removal of intact mammary implant 19330 Removal of mammary implant material 19355 Correction of inverted nipples 19370 Open periprosthetic capsulotomy, breast 19371 Periprosthetic capsulectomy, breast 19380 Revision of reconstructed breast...
by Medical Billing | May 24, 2017 | CPT modifiers
CPT Code Description Appendectomy Code Family 44950 Appendectomy 44955 Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) 44960 Appendectomy; for...
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