by Medical Billing | Jan 20, 2017 | CPT modifiers
Coverage Indications, Limitations, and/or Medical Necessity Noridian will provide limited coverage for the Prolaris™ prostate cancer assay (Myriad, Salt Lake City, UT) to help determine which patients with early stage, needle biopsy proven prostate cancer, can be...
by Medical Billing | Jan 14, 2017 | CPT modifiers
Procedure Codes and Description 81381 HLA CLASS I TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE ALLELE OR ALLELE GROUP (EG, B*57:01P), EACH 81383 HLA CLASS II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE ALLELE OR ALLELE GROUP (EG,...
by Medical Billing | Jan 11, 2017 | CPT modifiers
Procedure Codes Description Group 1 Codes: 0001M Infectious dis hcv 6 assays 0002M Liver dis 10 assays w/ash 0003M Liver dis 10 assays w/nash 0004M Scoliosis dna alys 0006M Onc hep gene risk classifier 0007M Onc gastro 51 gene nomogram 0008M Onc breast risk score...
by Medical Billing | Jan 10, 2017 | CPT modifiers
Background Out of necessity, multiple continuous peripheral nerve blocks (CPNB) were administered in Operation Iraqi Freedom in 2003. Real-time imaging (portable ultrasound) and peripheral nerve stimulation have revolutionized the practice of CPNB anesthesia by...
by Medical Billing | Jan 6, 2017 | CPT modifiers
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...
by Medical Billing | Nov 24, 2016 | CPT modifiers
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...
by Medical Billing | Nov 17, 2016 | CPT modifiers
Severity/Complexity Modifiers For each nonpayable functional G-code, one of the modifiers listed below must be used to report the severity/complexity for that functional limitation. Modifier ...
by Medical Billing | Nov 13, 2016 | CPT modifiers
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...
by Medical Billing | Nov 9, 2016 | CPT modifiers
Payment to the CAH for each outpatient visit (reassigned billing) will be the sum of the following: • For facility services, not including physician or other practitioner services, payment will be based on 101 percent of the reasonable costs of the services. List the...
by Medical Billing | Oct 25, 2016 | CPT modifiers
Procedure code and Description 99173 Screening test of visual acuity, quantitative, bilateral. 99174 Instrument-based ocular screening 99199 – Unlisted special service, procedure or report 99183 – Physician attendance and supervision of hyperbaric oxygen...
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