by Medical Billing | Oct 24, 2016 | CPT modifiers
Multiple E&M services on the same day • Reimbursement will be made for a preventive code with a problem focused code when modifier -25 is applied to the problem-focused code. Reimbursement for the preventive service will be made at 100% of the contracted...
by Medical Billing | Oct 21, 2016 | CPT modifiers
procedure code and description 22851 – Apply spine prosth device – average fee payment – $480 – $490 22840 Posterior non-segmental instrumentation (e.g. harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial...
by Medical Billing | Oct 19, 2016 | CPT modifiers
CODE DESCRIPTION MAXFEE 14000-2 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less $773.91 14001-2 defect 10.1 sq cm to 30.0 sq cm $1,136.94 14020-2 Adjacent tissue transfer or rearrangement, scalp, arms, legs; defect 10 sq cm or less $764.11...
by Medical Billing | Oct 18, 2016 | CPT modifiers
The Customary Charge The customary charge is the amount that best represents the actual charges made for a given medical service or by other persons who supply other medical and health services to the general public. Therefore, obtain information on the customary...
by Medical Billing | Oct 14, 2016 | CPT modifiers
There are two criteria in the Act that must be considered in determining the reasonable charge for a service. They are: • The customary charges for similar services generally made by the physician or other person furnishing such services; and • The prevailing charges...
by Medical Billing | Oct 10, 2016 | CPT modifiers
Modifier KX The KX modifier is a multipurpose, informational modifier and can be used to identify services for transgender, ambiguous genitalia, and hermaphrodite beneficiaries in addition to its other existing uses. Physicians and non-physician practitioners should...
by Medical Billing | Oct 6, 2016 | CPT modifiers
Modifiers provide a means to report or indicate a service or procedure that has been performed has been altered can be altered by a specific circumstance without changing the procedure code. Modifiers are used to increase accuracy in compensation, coding consistency,...
by Medical Billing | Oct 2, 2016 | CPT modifiers
GA Waiver of Liability Statement Issued, as Required by Payer Policy ABN required; beneficiary liable To signify a line item is linked to the mandatory use of an ABN when charges both related to and not related to an ABN must be submitted on the same claim Line...
by Medical Billing | Sep 29, 2016 | CPT modifiers
Physicians report the appropriate anesthesia modifier to denote whether the service was personally performed, medically directed, or medically supervised. Specific anesthesia modifiers include: AA – Anesthesia Services performed personally by the...
by Medical Billing | Sep 24, 2016 | CPT modifiers
Dialysis adequacy, infection and vascular access reporting Effective for dates of service on and after July 1, 2010, renal dialysis facilities will require new quality data reporting for: Dialysis adequacy. Infection. Vascular access. Under the PPACA providers...
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