Place of service (POS) 21, 22 , 23
POS code and Description21 Inpatient Hospital A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or...
View ArticleDental billing overview - Medicaid
DENTAL PROGRAM COVERAGEEARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENTThe Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program is available to all Medicaid beneficiaries under...
View ArticleDental billing covered and non covered services - Medicaid
COVERED SERVICESThis section provides information on Medicaid covered services and is divided into the following subsections that correspond to the categories of services in Current Dental Terminology...
View ArticleCPT feraheme j code , Q0138, Q0139, J1750, 11756, J2916
Ferumoxytol (Feraheme)Ferumoxytol is covered for the FDA-approved ages – 18 years of age and older.a. FDA-Approved IndicationsFerumoxytol is covered for all of the following FDA-approved indications:1....
View ArticleCPT code for wound care - 97597, 97598
Billing Guidelines*A. Wound Care (CPT Codes 97597, 97598 and 11042-11047)1. Active wound care is performed to remove devitalized and/or necrotic tissue to promote healing of a wound on the skin. These...
View ArticleHospice Service billing - Complete overview
Hospice Billing INTRODUCTIONHospice is a health care program designed to meet the needs of terminally ill individuals when the individual decides that the physical and emotional toll of curative...
View ArticleMedicaid Laboratory Billing Guide
LABORATORYMDHHS follows Medicare’s current OPPS coverage policies as closely as possible and appropriate. In those instances where program differences require coverage disparity, the differences will...
View Articlewhy post payment audit happening in insurances
POST-PAYMENT AUDITSBCBSKS conducts periodic post-payment audits of patient records and adjudicated claims to verify congruence with BCBSKS medical and payment policies, including medical necessity and...
View ArticleProvider signature requirements - Medical record
Signature RequirementsIn the content of health records, each entry must be authenticated by the author. Authentication is the process of providing proof of the authorship signifying knowledge,...
View ArticleMedicaid - DME - Guidelines and coverage policies
DURABLE MEDICAL EQUIPMENT, PROSTHETIC DEVICES, ORTHOTIC DEVICES, DISPOSABLE MEDICAL SUPPLIES (DMEPOS) PROGRAMA.GENERAL INFORMATION1.DMEPOS Program coverage areas include parenteral and enteral...
View ArticleCPT 99490, 99487, 99489 - Chronic Care Management Services - Medicare guidelines
Chronic Care Management Services - CCMCPT 99490 Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per...
View ArticlePathology billing - Medicare payment guidelines
Payment for Pathology ServicesA.Payment for Professional Component (PC) ServicesPayment may be made under the physician fee schedule for the professional component of physician laboratory or physician...
View ArticleCPT code list for infertility - 54500, g0027, s3655, 58322
IntroductionInfertility is a problem or problems with the reproductive system that affects the ability to conceive. Different types of reproductive problems affect men and women, but the end result...
View ArticleCPT 21010, 21050, 21116, 21240, 29800, 70330 -70355 - Temporomandibular Joint...
Coding Code Description CPT20605 Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)21010...
View ArticleCPT 95905, G0255 - Automated Point-of-Care Nerve Conduction Tests
Coding Code Description CPT95905 Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed,...
View ArticleCPT 0126T, 93895 - Assessment of Subclinical Atherosclerosis
Coding Code Description CPT0126T Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment93895 Quantitative carotid...
View ArticleCPT E0218, E0236, E0650,E0652, E1399 - Cooling Devices Used in the Outpatient...
Coding Code Description CPTE0218 Water circulating cold pad with pumpE0236 Pump for water circulating padE0650 Pneumatic Compressor, nonsegmental home modelE0651 Pneumatic compressor, segmental home...
View ArticleCPT 0278t, 97014, E7045,E7062, E1399, G0283, L8679 - Electrical Stimulation...
Coding Code Description CPT0278T Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)97014 Application of modality...
View ArticleCPT for Sublingual Immunotherapy as a Technique of Allergen- Specific Therapy...
Code Description CPT95199 Unlisted allergy/clinical immunologic service or procedureSublingual Immunotherapy as a Technique of Allergen- Specific TherapyIntroductionTreating allergies often involves...
View ArticleImmunization CPT full list - Medicare covered
CPT code and description90630 – Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use90653 – Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for...
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