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1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
NCCI was established to prevent fraud and abuse of the Medicare system by preventing improper payments for services. Medical billers with the proper training understand that HCPCS Level I codes are used to bill Medicare, a government health insurance program that covers 48 million Americans, who make up a large percentage of any healthcare facility’s patient population. Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
Medical billers with the proper training understand that HCPCS Level I codes are used to bill Medicare, a government health insurance program that covers 48 million Americans, who make up a large percentage of any healthcare facility’s patient population. Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs).
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare. While the guidelines are updated quarterly, a basic understanding of the use of HCPCS, and how they are meant to be used according to the NCCI, is essential to adapt to the ongoing changes in the healthcare industry.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare. While the guidelines are updated quarterly, a basic understanding of the use of HCPCS, and how they are meant to be used according to the NCCI, is essential to adapt to the ongoing changes in the healthcare industry. Employers can be assured that professional medical billers and certified medical coders have this understanding after they have successfully completed a formal program of study offered by an accredited institution that teaches medical billing and medical coding.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
This procedure is to be considered only for diagnostic services under Other Medical Benefits and is not to be considered as a routine/preventive screening service under Additional Benefits. Under the Blue Cross & Blue Shield Service Benefit Plan, routine services (i.e., services not related to a specific illness, injury, set of symptoms or maternity care) are excluded except for those preventive/routine services specifically described in the Service Benefit Plan brochure. Effective retroactively to November 17, 1999, and forward, for the Federal Employee Program (FEP) only, plans are to implement this policy immediately. Since there is no specific CPT code for EBCT scanning of the heart, providers may possibly code this service by using 71250, CT scan of the thorax. Claims for EBCT scanning of the heart may be identified by CPT 71250 in conjunction with an ICD-9 Diagnosis Code describing coronary artery disease.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
Effective retroactively to November 17, 1999, and forward, for the Federal Employee Program (FEP) only, plans are to implement this policy immediately. Since there is no specific CPT code for EBCT scanning of the heart, providers may possibly code this service by using 71250, CT scan of the thorax. Claims for EBCT scanning of the heart may be identified by CPT 71250 in conjunction with an ICD-9 Diagnosis Code describing coronary artery disease. (Document #00-081HR)
POLICY GUIDELINESInvestigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
(Document #00-081HR)
POLICY GUIDELINESInvestigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY2/1998: Approved by Medical Policy Advisory Committee (MPAC)
5/1999: Reviewed by MPAC; investigational status maintained
11/1999: Reviewed by MPAC; investigational status maintained for all indications
2/2000: Revisions for FEP only
2/8/2002: Investigational definition added
4/26/2002: Type of Service and Place of Service deleted
5/17/2002: Code Reference section completed
6/13/2002: Code Reference section updated
8/7/2002: Sources section updated
2/12/2004: Code Reference section updated, CPT code 76499 deleted
3/25/2004: Reviewed by MPAC, remains investigational, Policy title "Electron Beam Computed Tomography" renamed "Computed Tomography to Detect Coronary Artery Calcification", Description and Policy sections revised to be consistent with BCBSA policy # 6.01.03, Sources updated
5/19/2004: Code Reference section reviewed, no changes
3/13/2006: Coding updated. CPT4 2006 revisions added to policy
3/16/2006: Policy reviewed, no changes
6/29/2006: Code reference section updated, CPT codes 76376 and 76377 deleted. CPT codes 0146T, 0147T, 0148T, 0149T added to non-covered table.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY2/1998: Approved by Medical Policy Advisory Committee (MPAC)
5/1999: Reviewed by MPAC; investigational status maintained
11/1999: Reviewed by MPAC; investigational status maintained for all indications
2/2000: Revisions for FEP only
2/8/2002: Investigational definition added
4/26/2002: Type of Service and Place of Service deleted
5/17/2002: Code Reference section completed
6/13/2002: Code Reference section updated
8/7/2002: Sources section updated
2/12/2004: Code Reference section updated, CPT code 76499 deleted
3/25/2004: Reviewed by MPAC, remains investigational, Policy title "Electron Beam Computed Tomography" renamed "Computed Tomography to Detect Coronary Artery Calcification", Description and Policy sections revised to be consistent with BCBSA policy # 6.01.03, Sources updated
5/19/2004: Code Reference section reviewed, no changes
3/13/2006: Coding updated. CPT4 2006 revisions added to policy
3/16/2006: Policy reviewed, no changes
6/29/2006: Code reference section updated, CPT codes 76376 and 76377 deleted. CPT codes 0146T, 0147T, 0148T, 0149T added to non-covered table. 1/30/2007: Code reference section reviewed and updated.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
POLICY HISTORY2/1998: Approved by Medical Policy Advisory Committee (MPAC)
5/1999: Reviewed by MPAC; investigational status maintained
11/1999: Reviewed by MPAC; investigational status maintained for all indications
2/2000: Revisions for FEP only
2/8/2002: Investigational definition added
4/26/2002: Type of Service and Place of Service deleted
5/17/2002: Code Reference section completed
6/13/2002: Code Reference section updated
8/7/2002: Sources section updated
2/12/2004: Code Reference section updated, CPT code 76499 deleted
3/25/2004: Reviewed by MPAC, remains investigational, Policy title "Electron Beam Computed Tomography" renamed "Computed Tomography to Detect Coronary Artery Calcification", Description and Policy sections revised to be consistent with BCBSA policy # 6.01.03, Sources updated
5/19/2004: Code Reference section reviewed, no changes
3/13/2006: Coding updated. CPT4 2006 revisions added to policy
3/16/2006: Policy reviewed, no changes
6/29/2006: Code reference section updated, CPT codes 76376 and 76377 deleted. CPT codes 0146T, 0147T, 0148T, 0149T added to non-covered table. 1/30/2007: Code reference section reviewed and updated. CPT codes 0146T and 0148T deleted.
|
0144
|
Psych/Detox
|
RC
|
06/18/2014: Policy reviewed; description updated regarding CT angiography. Policy statement revised to change "electron-beam CT or spiral" to "computed tomography" to reflect the scope of the policy; intent unchanged. Removed deleted CPT code 0144T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy #6.01.03
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
|
0144
|
Psych/Detox
|
RC
|
Policy statement revised to change "electron-beam CT or spiral" to "computed tomography" to reflect the scope of the policy; intent unchanged. Removed deleted CPT code 0144T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy #6.01.03
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
|
0144
|
Psych/Detox
|
RC
|
Removed deleted CPT code 0144T from the Code Reference section. 07/13/2015: Code Reference section updated for ICD-10. SOURCE(S)Blue Cross Blue Shield Association policy #6.01.03
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.
|
1745
|
Thoracoscopic robotic assisted procedure
|
ICD
|
doi:10.1016/j.biopsych.2006.08.041. PMID 17141745. - World Health Organisation (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation.
|
1745
|
Thoracoscopic robotic assisted procedure
|
ICD
|
PMID 17141745. - World Health Organisation (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation. ISBN 978-92-4-154422-1.
|
31615
|
Visualization of windpipe
|
HCPCS
|
These are listed in Table B, with an explanation of the difference in code description from 2016. Two airway procedure codes, 31582 and 31588, were removed to correspond with the new and revised codes, noted above. Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017.
|
31588
|
Revision of larynx
|
HCPCS
|
These are listed in Table B, with an explanation of the difference in code description from 2016. Two airway procedure codes, 31582 and 31588, were removed to correspond with the new and revised codes, noted above. Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017.
|
31582
|
Revision of larynx
|
HCPCS
|
These are listed in Table B, with an explanation of the difference in code description from 2016. Two airway procedure codes, 31582 and 31588, were removed to correspond with the new and revised codes, noted above. Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017.
|
31622
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
HCPCS
|
These are listed in Table B, with an explanation of the difference in code description from 2016. Two airway procedure codes, 31582 and 31588, were removed to correspond with the new and revised codes, noted above. Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017.
|
43200
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
HCPCS
|
These are listed in Table B, with an explanation of the difference in code description from 2016. Two airway procedure codes, 31582 and 31588, were removed to correspond with the new and revised codes, noted above. Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017.
|
31615
|
Visualization of windpipe
|
HCPCS
|
Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists.
|
99499
|
HC CONSULTATIVE PHYSICIAN, PRIMARY PHYSICIAN, PSYCHOLOGISTS, NP
|
HCPCS
|
Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists.
|
31622
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
HCPCS
|
Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists.
|
43200
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
HCPCS
|
Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists.
|
99201
|
Office Visit New Min
|
HCPCS
|
Deletion of the “moderate sedation included” symbol () affected many otolaryngology endoscopy codes, such as 31615 Tracheobronchoscopy through established tracheostomy incision, the bronchoscopy codes (Eg: 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)), and many esophagoscopy codes (Eg: 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)). Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists.
|
99499
|
HC CONSULTATIVE PHYSICIAN, PRIMARY PHYSICIAN, PSYCHOLOGISTS, NP
|
HCPCS
|
Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists. For clinicians practicing only psychotherapy, CPT® created new psychotherapy codes.
|
99201
|
Office Visit New Min
|
HCPCS
|
Reporting Mental Health in Drug Screening. Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists. For clinicians practicing only psychotherapy, CPT® created new psychotherapy codes.
|
99499
|
HC CONSULTATIVE PHYSICIAN, PRIMARY PHYSICIAN, PSYCHOLOGISTS, NP
|
HCPCS
|
Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists. For clinicians practicing only psychotherapy, CPT® created new psychotherapy codes. This prompted the creation of new guidelines, new definitions, and clarification on time reporting.
|
99201
|
Office Visit New Min
|
HCPCS
|
Major changes have occurred in mental health coding and drug screen services.The evolving public awareness of mental health, parity laws, revisions to CDC guidelines, and HCPCS Level II dual coding for drug screen services prompted more changes in 2017. In 2013, CPT® created separate reporting guidelines for physicians and other mental health clinicians. CPT® instructed physicians to report medication management through evaluation and management (E/M) codes (99201-99499), with psychotherapy reported as an add-on code,
because physicians focus on the medication management of the patient, with referrals to therapists and psychologists. For clinicians practicing only psychotherapy, CPT® created new psychotherapy codes. This prompted the creation of new guidelines, new definitions, and clarification on time reporting.
|
80305
|
Urine Drug Screen[Panel]
|
HCPCS
|
In 2015, CPT® changed drug screening services to define them as either presumptive or definitive. The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.]
|
G0477
|
DRUG TST PRESUMP;CPBL BEING READ DC OPT OBV ONLY
|
HCPCS
|
In 2015, CPT® changed drug screening services to define them as either presumptive or definitive. The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.]
|
G0478
|
DRUG TEST PRESUMP;READ BY INSTRUM-AST DC OPT OBV
|
HCPCS
|
The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.]
|
80305
|
Urine Drug Screen[Panel]
|
HCPCS
|
The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.]
|
G0477
|
DRUG TST PRESUMP;CPBL BEING READ DC OPT OBV ONLY
|
HCPCS
|
The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.]
|
80306
|
Drug test prsmv instrmnt
|
HCPCS
|
The Centers for Medicare & Medicaid Services (CMS) still required providers to use an appropriate HCPCS Level II code, which CMS subsequently updated in 2016. HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.]
|
80307
|
TRAMADOL SCRN URINE CONFIRM
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
G0479
|
Drug test presump not opt
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
G0478
|
DRUG TEST PRESUMP;READ BY INSTRUM-AST DC OPT OBV
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
80305
|
Urine Drug Screen[Panel]
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
G0477
|
DRUG TST PRESUMP;CPBL BEING READ DC OPT OBV ONLY
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
80306
|
Drug test prsmv instrmnt
|
HCPCS
|
HCPCS Level II codes adopted by CMS in 2016 for presumptive drug screen services became popular among coders and payers, forcing CPT® to adopt these code definitions in 2017. With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.]
|
80307
|
TRAMADOL SCRN URINE CONFIRM
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
G0479
|
Drug test presump not opt
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
G0478
|
DRUG TEST PRESUMP;READ BY INSTRUM-AST DC OPT OBV
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
80305
|
Urine Drug Screen[Panel]
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
G0477
|
DRUG TST PRESUMP;CPBL BEING READ DC OPT OBV ONLY
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
80306
|
Drug test prsmv instrmnt
|
HCPCS
|
With the adoption of the new CPT® codes, CMS deleted the dual coding methodology for presumptive drug screen services in the HCPCS Level II codebook, creating a uniformed coding system for presumptive drug screen services. The new CPT® codes are:
- 80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0477.] - 80306 read by instrument assisted direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service [The old code was G0478.] - 80307Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed per date of service [The old code was G0479.] Presumptive drug screening services may be performed prior to definitive drug screen testing when a provider wants to:
- Rule out illicit drug uses;
- Confirm the presence of a particular drug class without identifying individual drugs; or
- Distinguish between structural isomers.
|
20526
|
PR INJECTION THERAPEUTIC CARPAL TUNNEL
|
HCPCS
|
To achieve coverage and payment, the provider should document the conservative treatment provided, along with the patient’s response to these methods. Following more conservative treatments, an injection performed in the wrist with corticosteroids and/or anesthetics can provide temporary relief of the symptoms. The injection is reported with 20526 Injection, therapeutic (Eg: Local anesthetic corticosteroid), carpal tunnel. If one performs this service in an office setting and purchase the medication, the corticosteroid using the appropriate HCPCS Level II code (In a hospital or outpatient setting, the facility codes for the drug) should be coded. A more productive intervention is for the physician to perform a release of the ligament, through either an endoscopic or open approach.
|
20526
|
PR INJECTION THERAPEUTIC CARPAL TUNNEL
|
HCPCS
|
Following more conservative treatments, an injection performed in the wrist with corticosteroids and/or anesthetics can provide temporary relief of the symptoms. The injection is reported with 20526 Injection, therapeutic (Eg: Local anesthetic corticosteroid), carpal tunnel. If one performs this service in an office setting and purchase the medication, the corticosteroid using the appropriate HCPCS Level II code (In a hospital or outpatient setting, the facility codes for the drug) should be coded. A more productive intervention is for the physician to perform a release of the ligament, through either an endoscopic or open approach. The endoscope is placed into the wrist through a small incision in the wrist joint.
|
1741
|
Open robotic assisted procedure
|
ICD
|
2005, 3: 12-10.1186/1741-7015-3-12. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. 2000, Washington, DC , American Psychiatric Association
World Health Organization: International Classification of Diseases, 10th Revision (ICD-10). 1992, Geneva, Switzerland , World Health Organization
Nakane Y, Jorm AF, Yoshioka K, Christensen H, Nakane H, Griffiths KM: Public beliefs about causes and risk factors for mental disorders: a comparison of Japan and Australia. BMC Psychiatry.
|
1500
|
New Technology - Level 1
|
APC
|
The American Academy of Professionals Coders (AAPC) provides physician-based coding certification courses, such as CPC certification. The organization offers both classroom and online training, which can be completed in less than 5 months. The course fee is $1500. The American Health Information Management Association (AHIMA) offers facility-based training courses – both certificate and degree programs. The coding training with AHIMA usually takes about 15 months to complete.
|
44950
|
PR APPENDECTOMY
|
HCPCS
|
it is a collection of standard prices for services and items that a provider organization offers. Computer-assisted coding (CAC) solutions can help speed up the medical coding process and increase coding accuracy and efficiency. For Evaluating Patient: CPT = 99285
ICD = K35.80
For Procedure: CPT = 44950
ICD = K35.80
The medical coder should have Industry specific skills such as ICD-10 coding, CPT coding, HCPCS coding, Medical terminology, Anatomy, Healthcare regulations, etc., and Professional skills such as Communication, critical thinking, Time management, Attention to detail, Research, and computer literacy. Quintessence is a leading Revenue cycle management services and technology company offering performance-guaranteed and effective solutions to Medical billing and Medical coding companies. Medical coding has a Financial aspect.
|
99285
|
PROFESSIONAL FEE LEVEL 5
|
HCPCS
|
it is a collection of standard prices for services and items that a provider organization offers. Computer-assisted coding (CAC) solutions can help speed up the medical coding process and increase coding accuracy and efficiency. For Evaluating Patient: CPT = 99285
ICD = K35.80
For Procedure: CPT = 44950
ICD = K35.80
The medical coder should have Industry specific skills such as ICD-10 coding, CPT coding, HCPCS coding, Medical terminology, Anatomy, Healthcare regulations, etc., and Professional skills such as Communication, critical thinking, Time management, Attention to detail, Research, and computer literacy. Quintessence is a leading Revenue cycle management services and technology company offering performance-guaranteed and effective solutions to Medical billing and Medical coding companies. Medical coding has a Financial aspect.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
The American Medical Association was first to introduce Current Procedural Terminology codes. It was in the 1960s and its aim was to enable medical staff to use standardized terms to document procedures and services in medical records. Nowadays, more than 10,000 different 6-digit CPT codes ranging between 00100 and 99499 exist and each code consists of six digits. Furthermore, two-digit modifying codes can be added with the aim to provide more clarification on the specifics of a procedure that has to be done. These additional digits in codes are required in cases when the code only describes a part of a procedure.
|
V2799
|
Misc vision item or service
|
HCPCS
|
PMID 19874111
- Vision, learning and dyslexia. A joint organizational policy statement of the American Academy of Optometry and the American Optometric Association. 1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services.
|
92065
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
HCPCS
|
PMID 19874111
- Vision, learning and dyslexia. A joint organizational policy statement of the American Academy of Optometry and the American Optometric Association. 1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services.
|
V2799
|
Misc vision item or service
|
HCPCS
|
A joint organizational policy statement of the American Academy of Optometry and the American Optometric Association. 1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed.
|
92065
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
HCPCS
|
A joint organizational policy statement of the American Academy of Optometry and the American Optometric Association. 1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed.
|
V2799
|
Misc vision item or service
|
HCPCS
|
1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed. New medically necessary statement added for convergence insufficiency; policy statement for learning disabilities changed to not medically necessary|
|1/12/12||Replace policy||Policy updated with literature search through November 2011; references added and reordered; policy statements unchanged|
|1/10/13||Replace policy||Policy updated with literature search through November 2012; policy statements unchanged|
|1/09/14||Replace policy||Policy updated with literature search through December 4, 2013; references 12 and 18 added.
|
92065
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
HCPCS
|
1997;
Accessed November, 2014. |CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed. New medically necessary statement added for convergence insufficiency; policy statement for learning disabilities changed to not medically necessary|
|1/12/12||Replace policy||Policy updated with literature search through November 2011; references added and reordered; policy statements unchanged|
|1/10/13||Replace policy||Policy updated with literature search through November 2012; policy statements unchanged|
|1/09/14||Replace policy||Policy updated with literature search through December 4, 2013; references 12 and 18 added.
|
V2799
|
Misc vision item or service
|
HCPCS
|
|CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed. New medically necessary statement added for convergence insufficiency; policy statement for learning disabilities changed to not medically necessary|
|1/12/12||Replace policy||Policy updated with literature search through November 2011; references added and reordered; policy statements unchanged|
|1/10/13||Replace policy||Policy updated with literature search through November 2012; policy statements unchanged|
|1/09/14||Replace policy||Policy updated with literature search through December 4, 2013; references 12 and 18 added. Policy statements unchanged.|
|1/15/15||Replace policy||Policy updated with literature review through December 3, 2014; references 22 and 25 added.
|
92065
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
HCPCS
|
|CPT||92065||Orthoptic and/or pleoptic training, with continuing medical direction and evaluation|
|ICD-9 Procedure||95.35||Orthoptic training|
|ICD-9 Diagnosis||315.00-315.09||Developmental reading disorder coding range|
|378.83||Other disorders of binocular eye movements; converge insufficiency or palsy|
|HCPCS||V2799||Vision service, miscellaneous|
|ICD-10-CM (effective 10/1/15)||H51.11 -H51.12||Convergence insufficiency and excess code range|
|F81.0||Specific reading disorder|
|ICD-10-CM (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. Policy is only for outpatient services.|
|Type of Service||Vision|
|Place of Service||Physician’s Office|
|7/31/96||Add to Vision section||New policy|
|7/12/02||Replace policy||Policy reviewed without literature search; new review date only|
|12/17/03||Replace policy||Policy reviewed with literature search; policy statement unchanged; additional discussion and references in Rationale section|
|03/15/05||Replace policy||Policy reviewed with literature search; policy statement unchanged|
|03/7/06||Replace policy||Policy reviewed with literature search; no change in policy statement|
|01/10/08||Replace Policy||Policy reviewed with literature search; reference 10 added; no change in policy statement.|
|03/12/09||Replace policy||Policy reviewed with literature search from January 2008 through January 2009; no change in policy statement.|
|01/13/11||Replace policy||Policy updated with literature review; references added and reordered, clinical input reviewed. New medically necessary statement added for convergence insufficiency; policy statement for learning disabilities changed to not medically necessary|
|1/12/12||Replace policy||Policy updated with literature search through November 2011; references added and reordered; policy statements unchanged|
|1/10/13||Replace policy||Policy updated with literature search through November 2012; policy statements unchanged|
|1/09/14||Replace policy||Policy updated with literature search through December 4, 2013; references 12 and 18 added. Policy statements unchanged.|
|1/15/15||Replace policy||Policy updated with literature review through December 3, 2014; references 22 and 25 added.
|
15878
|
Suction lipectomy upr extrem
|
HCPCS
|
changed from investigational to medically necessary as follows: "Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents. "; "The treatment of axillary hyperhidrosis is considered cosmetic and therefore not eligible for coverage." deleted, Code Reference section updated, ICD-9 diagnosis code 780.8 description revised and "Note" added covered table, HCPCS J0585 added covered table, non-covered table added, CPT code 15878, 17999, 97033 added non-covered table, ICD-9 procedure code 86.3, 86.83, 99.27 added non-covered table
11/18/2004: Reviewed by MPAC, Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents, consultation with a dermatologist, and prior authorization. Sources updated
5/5/2005: Code Reference section updated, ICD-9 diagnosis code 705.21 added with Note: "Use code 780.8 to report all forms of hyperhidrosis for dates of service prior to 10/1/2004. See POLICY statement for coverage information regarding the various forms of hyperhidrosis."
|
97033
|
SBT PTA IONTOPHORESIS EACH 15 MIN
|
HCPCS
|
changed from investigational to medically necessary as follows: "Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents. "; "The treatment of axillary hyperhidrosis is considered cosmetic and therefore not eligible for coverage." deleted, Code Reference section updated, ICD-9 diagnosis code 780.8 description revised and "Note" added covered table, HCPCS J0585 added covered table, non-covered table added, CPT code 15878, 17999, 97033 added non-covered table, ICD-9 procedure code 86.3, 86.83, 99.27 added non-covered table
11/18/2004: Reviewed by MPAC, Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents, consultation with a dermatologist, and prior authorization. Sources updated
5/5/2005: Code Reference section updated, ICD-9 diagnosis code 705.21 added with Note: "Use code 780.8 to report all forms of hyperhidrosis for dates of service prior to 10/1/2004. See POLICY statement for coverage information regarding the various forms of hyperhidrosis."
|
J0585
|
PR INJECTION,ONABOTULINUMTOXINA 1 UNITS
|
HCPCS
|
changed from investigational to medically necessary as follows: "Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents. "; "The treatment of axillary hyperhidrosis is considered cosmetic and therefore not eligible for coverage." deleted, Code Reference section updated, ICD-9 diagnosis code 780.8 description revised and "Note" added covered table, HCPCS J0585 added covered table, non-covered table added, CPT code 15878, 17999, 97033 added non-covered table, ICD-9 procedure code 86.3, 86.83, 99.27 added non-covered table
11/18/2004: Reviewed by MPAC, Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents, consultation with a dermatologist, and prior authorization. Sources updated
5/5/2005: Code Reference section updated, ICD-9 diagnosis code 705.21 added with Note: "Use code 780.8 to report all forms of hyperhidrosis for dates of service prior to 10/1/2004. See POLICY statement for coverage information regarding the various forms of hyperhidrosis."
|
17999
|
UNLISTED PROC SKIN SUBQ
|
HCPCS
|
changed from investigational to medically necessary as follows: "Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents. "; "The treatment of axillary hyperhidrosis is considered cosmetic and therefore not eligible for coverage." deleted, Code Reference section updated, ICD-9 diagnosis code 780.8 description revised and "Note" added covered table, HCPCS J0585 added covered table, non-covered table added, CPT code 15878, 17999, 97033 added non-covered table, ICD-9 procedure code 86.3, 86.83, 99.27 added non-covered table
11/18/2004: Reviewed by MPAC, Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents, consultation with a dermatologist, and prior authorization. Sources updated
5/5/2005: Code Reference section updated, ICD-9 diagnosis code 705.21 added with Note: "Use code 780.8 to report all forms of hyperhidrosis for dates of service prior to 10/1/2004. See POLICY statement for coverage information regarding the various forms of hyperhidrosis."
|
J0585
|
PR INJECTION,ONABOTULINUMTOXINA 1 UNITS
|
HCPCS
|
01/01/2009: Accredo preferred provider information removed. BCBSMS information added. 07/27/2009: Policy Description section updated for a clearer understanding of primary and secondary hyperhidrosis symptoms and treatments, Policy Statement section revised to add table with treatments considered medically necessary per region and treatments considered investigational per region for a clearer understanding of the intent of the policy, Policy Guidelines section updated to add features of hyperhidrosis, note added to HCPCS code J0585 under covered table, HCPCS code J0587 added to non covered table. 08/03/2010: Policy description updated to add new FDA information about the safety evaluation of botulinum toxin products and the new drug names established to reinforce individual potencies and prevent medication errors. Botulinum type A and botulinum B were changed to OnabotulinumtoxinA and RimabotulinumtoxinB, respectively, throughout the policy.
|
J0587
|
rimabotulinumtoxinB 5,000 unit/mL solution 1 mL Vial
|
HCPCS
|
01/01/2009: Accredo preferred provider information removed. BCBSMS information added. 07/27/2009: Policy Description section updated for a clearer understanding of primary and secondary hyperhidrosis symptoms and treatments, Policy Statement section revised to add table with treatments considered medically necessary per region and treatments considered investigational per region for a clearer understanding of the intent of the policy, Policy Guidelines section updated to add features of hyperhidrosis, note added to HCPCS code J0585 under covered table, HCPCS code J0587 added to non covered table. 08/03/2010: Policy description updated to add new FDA information about the safety evaluation of botulinum toxin products and the new drug names established to reinforce individual potencies and prevent medication errors. Botulinum type A and botulinum B were changed to OnabotulinumtoxinA and RimabotulinumtoxinB, respectively, throughout the policy.
|
J0585
|
PR INJECTION,ONABOTULINUMTOXINA 1 UNITS
|
HCPCS
|
BCBSMS information added. 07/27/2009: Policy Description section updated for a clearer understanding of primary and secondary hyperhidrosis symptoms and treatments, Policy Statement section revised to add table with treatments considered medically necessary per region and treatments considered investigational per region for a clearer understanding of the intent of the policy, Policy Guidelines section updated to add features of hyperhidrosis, note added to HCPCS code J0585 under covered table, HCPCS code J0587 added to non covered table. 08/03/2010: Policy description updated to add new FDA information about the safety evaluation of botulinum toxin products and the new drug names established to reinforce individual potencies and prevent medication errors. Botulinum type A and botulinum B were changed to OnabotulinumtoxinA and RimabotulinumtoxinB, respectively, throughout the policy. Added links to related medical policy.
|
J0587
|
rimabotulinumtoxinB 5,000 unit/mL solution 1 mL Vial
|
HCPCS
|
BCBSMS information added. 07/27/2009: Policy Description section updated for a clearer understanding of primary and secondary hyperhidrosis symptoms and treatments, Policy Statement section revised to add table with treatments considered medically necessary per region and treatments considered investigational per region for a clearer understanding of the intent of the policy, Policy Guidelines section updated to add features of hyperhidrosis, note added to HCPCS code J0585 under covered table, HCPCS code J0587 added to non covered table. 08/03/2010: Policy description updated to add new FDA information about the safety evaluation of botulinum toxin products and the new drug names established to reinforce individual potencies and prevent medication errors. Botulinum type A and botulinum B were changed to OnabotulinumtoxinA and RimabotulinumtoxinB, respectively, throughout the policy. Added links to related medical policy.
|
0929
|
Other Diagnostic Services - Other Diagnostic Service
|
RC
|
The WHO Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: ICD-MM. World Health Organization; Geneva. 2011. https://apps.who.int/iris/bitstream/handle/10665/70929/9789241548458_eng.pdf. Accessed 12 October 2021. Ameh CA, Adegoke A, Pattinson RC, van den Broek N. Using the new ICD-MM classification system for attribution of cause of maternal death–a pilot study.
|
0929
|
Other Diagnostic Services - Other Diagnostic Service
|
RC
|
2011. https://apps.who.int/iris/bitstream/handle/10665/70929/9789241548458_eng.pdf. Accessed 12 October 2021. Ameh CA, Adegoke A, Pattinson RC, van den Broek N. Using the new ICD-MM classification system for attribution of cause of maternal death–a pilot study. BJOG. 2014;121(Suppl 4):32–40.
|
92135
|
Ophth dx imaging post seg
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY5/1998: Approved by Medical Policy Advisory Committee (MPAC)
4/12/2001: Managed Care Requirements deleted
5/2001: Reviewed by MPAC; investigational status remains
2/7/2002: Investigational definition added
5/2/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section completed
11/2002: Reviewed by MPAC; Scanning Laser Polarimetry (SLP) changed to medically necessary
7/2003: Reviewed by MPAC; "Description" section revised to be consistent with BCBSA, scanning laser ophthalmoscopy and optical coherence tomography are medically necessary for high risk individuals, scanning laser ophthalmoscopy, optical coherence tomography and scanning laser polarimetry are considered investigational as a method of monitoring disease progression in patients with glaucoma and as a screening test for glaucoma in the general population, measurement of pulsatile ocular blood flow or blood flow velocity with doppler ultrasonography is considered investigational in the diagnosis and follow-up of patients with glaucoma, FEP exception added
11/1/2004: Code Reference section updated, CPT code 92135 moved to covered, ICD-9 procedure code 88.90 added covered codes, ICD-9 diagnosis code 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.70, 250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 250.90, 250.91, 250.92, 250.93, 360.21, 362.85, V19.0 added covered codes, ICD-9 diagnosis 365.00, 365.01, 365.02, 365.03, 365.04, 365.10, 365.11, 365.12, 365.13, 365.14, 365.15, 365.20, 365.21, 365.22, 365.23, 365.24, 365.31, 365.32, 365.41, 365.42, 365.43, 365.44, 365.51, 365.52, 365.59, 365.60, 365.61, 365.62, 365.63, 365.64, 365.65, 365.81, 365.82, 365.83, 365.89, 365.9 description revised and moved from non-covered to covered, CPT code 93875 added to non-covered codes
1/10/2005: Code Reference section updated, ICD-9 diagnosis code 362.01, 362.02, 368.40, 368.41, 368.42, 368.43, 368.44, 368.45, 368.46, 368.47 added covered codes, HCPCS S0820 deleted
11/16/2005: Code Reference section updated, ICD9 diagnosis codes 362.03 - 362.07 added
3/17/2006: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
1/18/2008: Policy reviewed, no changes
9/16/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions
08/03/2010: Policy Description revised to remove optic nerve head analyzers. Policy statement revised to remove optic nerve head analyzers and analysis of the optic nerve (retinal nerve fiber layer) in the diagnosis and evaluation of patients with glaucoma or glaucoma suspects may be considered medically necessary when using scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography. FEP verbiage revised in Policy Exceptions section.
|
93875
|
Extracranial study
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY5/1998: Approved by Medical Policy Advisory Committee (MPAC)
4/12/2001: Managed Care Requirements deleted
5/2001: Reviewed by MPAC; investigational status remains
2/7/2002: Investigational definition added
5/2/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section completed
11/2002: Reviewed by MPAC; Scanning Laser Polarimetry (SLP) changed to medically necessary
7/2003: Reviewed by MPAC; "Description" section revised to be consistent with BCBSA, scanning laser ophthalmoscopy and optical coherence tomography are medically necessary for high risk individuals, scanning laser ophthalmoscopy, optical coherence tomography and scanning laser polarimetry are considered investigational as a method of monitoring disease progression in patients with glaucoma and as a screening test for glaucoma in the general population, measurement of pulsatile ocular blood flow or blood flow velocity with doppler ultrasonography is considered investigational in the diagnosis and follow-up of patients with glaucoma, FEP exception added
11/1/2004: Code Reference section updated, CPT code 92135 moved to covered, ICD-9 procedure code 88.90 added covered codes, ICD-9 diagnosis code 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.70, 250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 250.90, 250.91, 250.92, 250.93, 360.21, 362.85, V19.0 added covered codes, ICD-9 diagnosis 365.00, 365.01, 365.02, 365.03, 365.04, 365.10, 365.11, 365.12, 365.13, 365.14, 365.15, 365.20, 365.21, 365.22, 365.23, 365.24, 365.31, 365.32, 365.41, 365.42, 365.43, 365.44, 365.51, 365.52, 365.59, 365.60, 365.61, 365.62, 365.63, 365.64, 365.65, 365.81, 365.82, 365.83, 365.89, 365.9 description revised and moved from non-covered to covered, CPT code 93875 added to non-covered codes
1/10/2005: Code Reference section updated, ICD-9 diagnosis code 362.01, 362.02, 368.40, 368.41, 368.42, 368.43, 368.44, 368.45, 368.46, 368.47 added covered codes, HCPCS S0820 deleted
11/16/2005: Code Reference section updated, ICD9 diagnosis codes 362.03 - 362.07 added
3/17/2006: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
1/18/2008: Policy reviewed, no changes
9/16/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions
08/03/2010: Policy Description revised to remove optic nerve head analyzers. Policy statement revised to remove optic nerve head analyzers and analysis of the optic nerve (retinal nerve fiber layer) in the diagnosis and evaluation of patients with glaucoma or glaucoma suspects may be considered medically necessary when using scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography. FEP verbiage revised in Policy Exceptions section.
|
S0820
|
COMPUTERIZED CORNEAL TOPOGRA
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY5/1998: Approved by Medical Policy Advisory Committee (MPAC)
4/12/2001: Managed Care Requirements deleted
5/2001: Reviewed by MPAC; investigational status remains
2/7/2002: Investigational definition added
5/2/2002: Type of Service and Place of Service deleted
5/29/2002: Code Reference section completed
11/2002: Reviewed by MPAC; Scanning Laser Polarimetry (SLP) changed to medically necessary
7/2003: Reviewed by MPAC; "Description" section revised to be consistent with BCBSA, scanning laser ophthalmoscopy and optical coherence tomography are medically necessary for high risk individuals, scanning laser ophthalmoscopy, optical coherence tomography and scanning laser polarimetry are considered investigational as a method of monitoring disease progression in patients with glaucoma and as a screening test for glaucoma in the general population, measurement of pulsatile ocular blood flow or blood flow velocity with doppler ultrasonography is considered investigational in the diagnosis and follow-up of patients with glaucoma, FEP exception added
11/1/2004: Code Reference section updated, CPT code 92135 moved to covered, ICD-9 procedure code 88.90 added covered codes, ICD-9 diagnosis code 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.70, 250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 250.90, 250.91, 250.92, 250.93, 360.21, 362.85, V19.0 added covered codes, ICD-9 diagnosis 365.00, 365.01, 365.02, 365.03, 365.04, 365.10, 365.11, 365.12, 365.13, 365.14, 365.15, 365.20, 365.21, 365.22, 365.23, 365.24, 365.31, 365.32, 365.41, 365.42, 365.43, 365.44, 365.51, 365.52, 365.59, 365.60, 365.61, 365.62, 365.63, 365.64, 365.65, 365.81, 365.82, 365.83, 365.89, 365.9 description revised and moved from non-covered to covered, CPT code 93875 added to non-covered codes
1/10/2005: Code Reference section updated, ICD-9 diagnosis code 362.01, 362.02, 368.40, 368.41, 368.42, 368.43, 368.44, 368.45, 368.46, 368.47 added covered codes, HCPCS S0820 deleted
11/16/2005: Code Reference section updated, ICD9 diagnosis codes 362.03 - 362.07 added
3/17/2006: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
1/18/2008: Policy reviewed, no changes
9/16/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions
08/03/2010: Policy Description revised to remove optic nerve head analyzers. Policy statement revised to remove optic nerve head analyzers and analysis of the optic nerve (retinal nerve fiber layer) in the diagnosis and evaluation of patients with glaucoma or glaucoma suspects may be considered medically necessary when using scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography. FEP verbiage revised in Policy Exceptions section.
|
99499
|
HC CONSULTATIVE PHYSICIAN, PRIMARY PHYSICIAN, PSYCHOLOGISTS, NP
|
HCPCS
|
In this
situation, you would add a/an
Level II code. When a neonate or infant is not considered critically ill but still needs intensive observation and other
intensive care services, the initial and continuing intensive care services codes are
99499, unlisted evaluation and management services. What CPT code is assigned to an ED service that has a detailed history and exam with a moderate level
What type of code includes all the words that describe the procedure the code represents? The _______ is the universal health insurance form for submission of outpatient services. J codes in the HCPCS Level II system are used to indicate
medications and dosages.
|
A4638
|
Repl batt pulse gen sys
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY11/2003: Approved by Medical Policy Advisory Committee (MPAC)
2/16/2004: Code Reference section completed
11/3/2004: Code Reference section updated, ICD-9 diagnosis code 386.00, 386.01, 386.02, 386.03, 386.04 deleted, HCPCS E1399 deleted, HCPCS A4638, E2120 added
3/26/2007: Policy reviewed, no changes
9/26/2008: Policy reviewed, no changes
04/13/2010: Policy description updated. Policy statement unchanged. FEP verbiage added to the Policy Exceptions section.
|
E2120
|
Pulse gen sys tx endolymp fl
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY11/2003: Approved by Medical Policy Advisory Committee (MPAC)
2/16/2004: Code Reference section completed
11/3/2004: Code Reference section updated, ICD-9 diagnosis code 386.00, 386.01, 386.02, 386.03, 386.04 deleted, HCPCS E1399 deleted, HCPCS A4638, E2120 added
3/26/2007: Policy reviewed, no changes
9/26/2008: Policy reviewed, no changes
04/13/2010: Policy description updated. Policy statement unchanged. FEP verbiage added to the Policy Exceptions section.
|
90805
|
Psytx off 20-30 min w/e&m
|
HCPCS
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
38221
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
HCPCS
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
99263
|
Follow-up inpatient consult
|
HCPCS
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
99261
|
Follow-up inpatient consult
|
HCPCS
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
99054
|
MEDICAL SERVICES-UNUSUAL HRS
|
CPT
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
38211
|
Tumor cell deplete of harvst
|
HCPCS
|
The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System).
|
90805
|
Psytx off 20-30 min w/e&m
|
HCPCS
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
38221
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
HCPCS
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
99263
|
Follow-up inpatient consult
|
HCPCS
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
99261
|
Follow-up inpatient consult
|
HCPCS
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
99054
|
MEDICAL SERVICES-UNUSUAL HRS
|
CPT
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
38211
|
Tumor cell deplete of harvst
|
HCPCS
|
Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS.
|
90805
|
Psytx off 20-30 min w/e&m
|
HCPCS
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
38221
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
HCPCS
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
99263
|
Follow-up inpatient consult
|
HCPCS
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
99261
|
Follow-up inpatient consult
|
HCPCS
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
99054
|
MEDICAL SERVICES-UNUSUAL HRS
|
CPT
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
38211
|
Tumor cell deplete of harvst
|
HCPCS
|
CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels.
|
90805
|
Psytx off 20-30 min w/e&m
|
HCPCS
|
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two.
|
38221
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
HCPCS
|
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two.
|
99263
|
Follow-up inpatient consult
|
HCPCS
|
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two.
|
99261
|
Follow-up inpatient consult
|
HCPCS
|
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two.
|
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