Documentation is required when billing modifier 24
Based on widespread probes of office evaluation and management (E/M) services, First Coast has discovered that the 24 modifier for E/M services, when billing within a global surgery period, has been...
View ArticleHow to use Bilateral Services and CPT Modifier -50 and payment policy
DescriptionBilateral services are procedures performed on both sides of the body during the same session or on the same day.The HCPCS modifiers -LT and -RT are used when the procedure is valid for a...
View ArticleCPT CODE G0436, G0437 and coverage benefits
Counseling to Prevent Tobacco Use (for Asymptomatic Beneficiaries)HCPCS/CPT CodesG0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3...
View ArticleUsage of AT (Active Treatment ) Modifier
The Active Treatment (AT) modifier defines the difference between active treatment and maintenance treatment. Effective October 1, 2004, the AT Modifier is required under Medicare billing to receive...
View ArticleSurgical Mofiers 50, 52 , 57, 58 When to use
ModifiersUse the following modifiers, as applicable:Bill Use Modifier Other InformationBilateral surgery 50 Refer to the Bilateral Services and CPT Modifier 50 Payment Policy for billing...
View ArticleInfluenza Virus Vaccine and Administration and Glaucoma screening CPT codes
Glaucoma ScreeningHCPCS/CPT CodesG0117 – By an optometrist or ophthalmologistG0118 – Under the direct supervision of an optometrist or ophthalmologistICD-10-CM CodesZ13.5Who Is CoveredMedicare...
View ArticleCPT CODE G0446 AND covered frequency
Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD) Also known as a CVD risk reduction visitHCPCS/CPT CodesG0446 – Annual, face-to-face intensive behavioral therapy for...
View ArticleUsing Modifier 59, 76, 91 to prevent Duplicate denials
Preventing duplicate claim denialsProviders are responsible for all claims submitted to Medicare under their provider number. Preventable duplicate claims are counterproductive and costly, and...
View ArticlePI and PS Modifier for PET SCAN
B. Modifiers for PET ScansEffective for claims with dates of service on or after April 3, 2009, the following modifiers have been created for use to inform for the initial treatment strategy of...
View ArticleCPT CODE 90669, 90670, 90732 & G0009 ICD 10 CODE Z23
Pneumococcal Vaccine and AdministrationHCPCS/CPT Codes90669 – Pneumococcal conjugate vaccine, polyvalent, for children under 5 years, for intramuscular use90670 – Pneumococcal Conjugate Vaccine90732 –...
View ArticleCPT CODE 59425, 59426 And S5100 with modifier usage
Incomplete Antepartum Care Service CPTBilling for Incomplete Antepartum Care59425 When billing for four to six prenatal visits59426 When billing for seven or more prenatal visits with or without an...
View ArticleWell child care CPT codes full list
The following chart outlines appropriate CPT codes to use when billing for well-child care services and the number allowed at each age interval.ServiceProcedure CodesOffice Visit Hospital Visit...
View ArticleFQHC and IHC CPT CODES T1015 with POS and Modifier
Clinic/Center-Federally Qualified Health Center (FQHC)Bill the encounter using procedure code T1015 with the appropriate rate on the first detail line. Providers are required to list all the CPT/HCPCS...
View ArticlePayment for service incident to Admission
PolicyServices rendered prior to a related inpatient admission are considered incidental to admission and are included in the inpatient reimbursement rate.Services that are incidental to an admission...
View ArticleCPT code sexually transmitted infection screening
Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIsHCPCS/CPT Codes86631, 86632, 87110, 87270, 87320, 87490,87491, 87810 –...
View Articlehow to use JW modifier
Effective July 1, 2016, providers are required to:• Use the JW modifier for claims with unused drugs or biologicals from single use vials or single use packages that are appropriately discarded (except...
View ArticleDME Modifiers- AU, AV, AW, KM & KN
Payment of DMEPOS Items Based on ModifiersThe following modifiers were added to the HCPCS to identify supplies and equipment that may be covered under more than one DMEPOS benefit category:• AU Item...
View ArticleCPT CODE G0123, G0141, P3000, P3001 AND Q0091 - covered ICD 10 CODE
Screening Pap TestsHCPCS/CPT CodesG0123, G0124, G0141, G0143, G0144,G0145, G0147, G0148 – Screening cytopathology, cervical or vaginalP3000 – Screening Pap smear by technician under physician...
View ArticleGlobal Surgery modifiers - 24, 25 and 57 - payment Guide
Payment for Evaluation and Management Services Provided During Global Period of SurgeryA. CPT Modifier “-24” - Unrelated Evaluation and Management Service by Same Physician During Postoperative...
View ArticleAll info about NDC CODE - When to use UN, ML,GM with example
NDC CodeAn NDC (National Drug Code) is a unique identifier which identifies a specific drug. Even though an NDC Code is assigned to a drug, the drug may not be approved by the FDA. The NDC code(s)...
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