ASCQR PROGRAM SURGICAL PROCEDURE CODES FOR ASC-7
|
|
|
- Tracy Evans
- 6 years ago
- Views:
Transcription
1 ASCQR PROGRAM SURGICAL PROCEDURE CODES FOR ASC-7 This document summarizes the Ambulatory Surgical Center Quality Reporting (ASCQR) Program surgical procedure codes, grouped by organ system, to be used in answering measure ASC-7: ASC Facility Volume Data on Selected ASC Surgical Procedures. All codes were found on unless otherwise noted. The reference period for the collection of these data is January 1, 2014 through December 31, These data are to be submitted via the QualityNet Secure Portal during the submission period of January 1, 2015 through August 15, If you have any questions, please us at or call us toll-free at from 7 a.m. to 6 p.m. ET. Organ System: Eye Organ transplant (eye) Keratoplasty (corneal transplant); endothelial V2785* Processing, preserving and transporting corneal tissue Laser procedure of eye Trabeculoplasty by laser surgery, one or more sessions (defined treatment series) Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (per session) Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., yag laser) (one or more stages) Glaucoma procedures Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery Ciliary body destruction; cyclophotocoagulation, endoscopic Cataract procedures Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification) Injection of eye Intravitreal injection of a pharmacologic agent (separate procedure) J2778* Injection, ranibizumab, 0.1 mg J3300* Injection, triamcinolone acetonide, preservative free, 1 mg Retina, macular, and posterior segment procedures Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (e.g., for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (i.e., air, gas, or silicone oil) Destruction of localized lesion of retina (e.g., macular edema, tumors), one or more sessions; photocoagulation Repair of surrounding eye structures Blepharoplasty, upper eyelid; with excessive skin weighting down lid Repair of brow ptosis (supraciliary, mid-forehead, or coronal approach) Repair of blepharoptosis; (tarso) levator resection or advancement, external approach Repair of ectropion; extensive (e.g., tarsal strip operations) Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation) June 2014 Page 1 of 6
2 Organ System: Gastrointestinal GI endoscopy procedures Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) Sigmoidoscopy, flexible; with biopsy, single or multiple Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), any substance Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Hemorrhoidectomy, internal, by rubber band ligation(s) Swallowing tube (esophagus) Dilation of esophagus, by unguided sound or bougie, single or multiple passes Hernia repair Repair initial inguinal hernia, age five years or older; reducible GI screening procedures G0105* Colorectal cancer screening; colonoscopy on individual at high risk G0121* Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk June 2014 Page 2 of 6
3 Organ System: Genitourinary Kidney stone fragmentation Lithotripsy, extracorporeal shock wave Bladder-related procedures Cystourethroscopy (separate procedure) Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., gibbons or double-j type) Prostate biopsy Biopsy, prostate; needle or punch, single or multiple, any approach Radiologic procedures (GU) Urography, retrograde, with or without KUB Ultrasound procedures (GU) Ultrasound, transrectal June 2014 Page 3 of 6
4 Organ System: Musculoskeletal Joint or muscle aspiration or injection Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa) Removal of musculoskeletal implants Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod, or plate) Repair of foot, toes, fingers, and wrist Tendon sheath incision (e.g., for trigger finger) Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy) Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (e.g., mitchell, chevron, or concentric type procedures) Endoscopy, wrist, surgical, with release of transverse carpal ligament Joint arthroscopy Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure) Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code for primary procedure) Arthroscopy, shoulder, surgical; with rotator cuff repair Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed Joint or muscle aspiration or injection Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed Arthroscopy, shoulder, surgical; debridement, extensive Arthroscopy, shoulder, surgical; debridement, limited Musculoskeletal drug injection J0585* Injection, onabotulinumtoxina, 1 unit J0878* Injection, daptomycin, 1 mg J0131* Injection, acetaminophen, 10 mg June 2014 Page 4 of 6
5 Organ System: Nervous Injection procedures in or around the spine Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional level (list separately in addition to code for primary procedure) Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure) Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure) Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure) Destruction by neurolytic agent; other peripheral nerve or branch G0260* Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography J2278* Injection, ziconotide, 1 mcg Device implant Percutaneous implantation of neurostimulator electrode array, epidural Repair of foot, toes, fingers, and wrist Neuroplasty and/or transposition; median nerve at carpal tunnel June 2014 Page 5 of 6
6 Organ System: Respiratory Sinus procedure Submucous resection inferior turbinate, partial or complete, any method Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior) Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus Organ System: Skin Skin procedures including debridement, reconstructive, wound closure, excision and/or repair Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq. cm or less Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq. cm or less Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq. cm or less Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq. cm or less Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) Q4101* Apligraf, per square centimeter Q4102* Oasis wound matrix, per square centimeter Q4106* Dermagraft, per square centimeter Organ System: Multi-System Brachytherapy C2638* Brachytherapy source, stranded, iodine-125, per source C2639* Brachytherapy source, non-stranded, iodine-125, per source C2640* Brachytherapy source, stranded, palladium-103, per source C2641* Brachytherapy source, non-stranded, palladium-103, per source Cancer treatment with angiogenesis inhibitor C9257* Injection, bevacizumab, 0.25 mg * Source: This material was prepared by FMQAI, the Support Center for the Ambulatory Surgical Center Quality Reporting program, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). The contents presented do not necessarily reflect CMS policy. FL-10SOW-2014FS4T June 2014 Page 6 of 6
Orthopedic Coding Changes for 2012
Orthopedic Coding Changes for Lynn M. Anderanin, CPC,CPC-I, COSC Vertebroplasty 22520- Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral injection; thoracic 22520- Percutaneous vertebroplasty,
1 640 Normal Newborn, Birthweight 2500g+ $2,718 $1,658 $ Vaginal Delivery $6,410 $3,910 $2,244
Fort HealthCare 611 East Sherman Avenue Fort Atkinson, WI 53538 920-568-5000 s for 75 Most Common Types of Hospitalizations in Wisconsin: April 2011 - March 2012 (Uncomplicated Cases Only) NR = No Cases
Information Technology Solutions
2016 2014 CPT Esophagoscopy Changes - Gastroenterology CPT Changes Information Technology Solutions ASGE LOGO AND INFO Esophagogastroduodenoscopy CPT Codes 43235-43270 The American Society for Gastrointestinal
SURGERY CENTER SUMMARY OF SERVICES AND AVERAGE PRICING
SURGERY CENTER SUMMARY OF SERVICES AND AVERAGE PRICING Prices Include the Following: Facility, Surgeon, Anesthesia, immediate pre- and post-op care & surgical supplies. Implants, when applicable, are excluded,
Page 1 of 6 Fort HealthCare 611 East Sherman Avenue Fort Atkinson, WI 53538 920-568-5000 Print this report Rank Charges for 75 Most Common Types of Hospitalizations in Wisconsin: October 2011 - September
The number following the procedure code is the TRICARE payment group. KIDNEY
TRICARE/CHAMPUS POLICY MANUAL 6010.47-M JUNE 25, 1999 S POLICY CHAPTER 13 SECTION 9.1 ADDENDUM 1, SECTION 8 TRICARE-APPROVED AMBULATORY SURGERY S - URINARY SYSTEM The number following the procedure code
INDIANA HEALTH COVERAGE PROGRAMS
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER CODE TABLES Note: Due to possible changes in Indiana Health Coverage Programs (IHCP) policy or national coding updates, inclusion of a code on the code tables
ASPEN MEDICAL SURGERY REGINA
It is hereby certified that ASPEN MEDICAL SURGERY REGINA Has successfully completed an inspection as is required under the College s Bylaw 26.1 and is therefore approved as a Non Hospital Treatment Facility
1 640 Normal Newborn, Birthweight 2500g+ $3,032 $1,850 $1, Vaginal Delivery $6,350 $3,874 $2,223
Fort HealthCare 611 East Sherman Avenue Fort Atkinson, WI 53538 920-568-5000 s for 75 Most Common Types of Hospitalizations in Wisconsin: January 2012 - December 2012 (Uncomplicated Cases Only) NR = No
Shoulder Subacromial Decompression. 15 CPT & Coding Issues for Orthopedic & Spine ASC Facilities. 15 CPT & Coding Issues for Orthopedics and Spine
Orthopedics and Spine 12th Annual Orthopedic, Spine & Pain Management- Driven ASC The Future of Spine Conference by Becker s ASC Review & Becker s Spine Review Speaker Stephanie Ellis, R.N., CPC Ellis
2014 Deleted CPT Codes
2014 Deleted CPT Codes Surgery 13150 - Repair, complex, eyelids, nose, ears and/or lips; 1.0 cm or less 19102 - Biopsy of breast; percutaneous, needle core, using imaging guidance 19103 - Biopsy of breast;
Chapter 11 Worksheet Code It
Class: Date: Chapter 11 Worksheet 3 2 1 Code It True/False Indicate whether the statement is true or false. 1. Surgical destruction is considered part of the surgical procedure description. 2. Prepping
Understanding Your Costs and Coverage
Understanding Your Costs and Coverage Thank you for choosing UW. We know that understanding your healthcare costs can be a challenge we re here to help. Your healthcare costs depend on many factors such
evicore MSK joint surgery procedures requiring prior authorization
evicore MSK joint surgery procedures requiring prior authorization Moda Health Commercial Group and Individual Members* Updated 1/30/2018 *Check EBT to verify member enrollment in evicore program Radiology
BC ADVANTAGE AUDIO SERIES:
BC ADVANTAGE AUDIO SERIES: UPDATES FOR 2015 SURGICAL CPT CODES 1 Presented by: Darlene Boschert, RHIA, CPC, CPC-H, CPC-I Providing LOW-COST educational resources for Medical office Professionals OBJECTIVES
MSK Covered Services. Musculoskeletal: Joint Metal-on-metal total hip resurfacing, including acetabular and femoral components
CPT CODE S2118 MSK Covered Services Musculoskeletal: Joint Metal-on-metal total hip resurfacing, including acetabular and femoral components 23000 Removal of subdeltoid calcareous deposits, open 23020
Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatry. Procedure List. As Of. 01 April Government of Alberta
Alberta Health Care Insurance Plan Procedure List As Of 01 April 2017 Alberta Health Care Insurance Plan Page i Generated 2017/03/14 TABLE OF CONTENTS As of 2017/04/01 II. OPERATIONS ON THE NERVOUS SYSTEM.......................
1 640 Normal Newborn, Birthweight 2500g+ $3,741 $2,245 $ Vaginal Delivery $9,133 $5,480 $2,192
Fort HealthCare 611 East Sherman Avenue Fort Atkinson, WI 53538 800-844-5575 s for 75 Most Common Hospitalizations in Wisconsin: October 2015 - September 2016 (Uncomplicated Cases Only) NR = No Cases Reported
2012 CPT Changes Affecting Radiology REVISIONS
2012 CPT Changes Affecting Radiology REVISIONS 22520 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; thoracic 22521 lumbar 22522
22110 vertebral segment; cervical vertebral segment; thoracic vertebral segment; lumbar
The following codes are authorized by Palladian Health for applicable product lines. Visit palladianhealth.com to request authorization and to access guidelines. Palladian Musculoskeletal Program Codes
Cpt code for nerve repair
Cpt code for nerve repair + + + Nerve Procedures CPT Codes. Neurolysis Neuroma Repair Excise Tumor Nerve Graft Sympathectomy Secret Fun Links! American Society for. Surgery Feb 1, 2018. Nerve autografts
Clinical Documentation Excellence: CPT Coding Updates for Missy Vance, RHIA, CCS, CPC, AHIMA Approved ICD-10-CM/PCS Trainer & Ambassador
Clinical Documentation Excellence: CPT Coding Updates for 2015 Missy Vance, RHIA, CCS, CPC, AHIMA Approved ICD-10-CM/PCS Trainer & Ambassador Kelly Spell, CCS, CPC, CPC-H, CAHIMS, AHIMA Approved ICD-10-CM/PCS
PAIN MANAGEMENT CODES PRIOR AUTHORIZATION REQUIRED THROUGH EVICORE HEALTHCARE
PAIN MANAGEMENT CODES PRIOR AUTHORIZATION REQUIRED THROUGH EVICORE HEALTHCARE The following CPT/HCPCS codes for pain management require prior authorization through evicore healthcare. In order to request
OUTPATIENT Surgery Estimates APPENDECTOMY-laparoscopic: $17, Open-none in 2018 in OPS setting OBS PTS (laparoscopic) $27,973.
OUTPATIENT Surgery Estimates 2019 APPENDECTOMY-laparoscopic: $17,852.53 Open-none in 2018 in OPS setting OBS PTS (laparoscopic) $27,973.96 BILATERAL TUBAL LIGATION Laparoscopic using clips: $17,193.28
Hip, Knee and Shoulder Surgery
Hip, Knee and Shoulder Surgery Policy Number: MM.06.030 Lines of Business: HMO; PPO; QUEST Integration; Medicare Advantage Section: Surgery Place(s) of Service: Outpatient; Inpatient Original Effective
CPT 2014 Overview of GI Changes
CPT 2014 Overview of GI Changes The following table is a listing of the new,, and deleted codes in the Esophagus/Endoscopy section effective January 1, 2014. The table lists the CPT code, a brief description
Chapter 12 Worksheet Code It
Class: Date: Chapter 12 Worksheet 3 2 1 Code It True/False Indicate whether the statement is true or false. 1. The type of fracture corresponds to the type of treatment. 2. An open fracture is always treated
2017 FINAL - Physician Payment Rates rates compared to 2016 rates
Injection, therapeutic (eg, local anesthetic; corticosteroid), carpal tunnel 20526 $79.18 $59.47 $79.06 $59.74 $78.96 $59.58-0.3% 0.2% tendon sheath, ligament injection 20550 $60.19 $42.99 $54.02 $40.78
Colorectal Cancer Screening And Related Ancillary Services
Manual: Policy Title: Reimbursement Policy Colorectal Cancer Screening And Related Ancillary Services Section: Preventive Services Subsection: None Date of Origin: 11/20/2015 Policy Number: RPM046 Last
2017 PHYSICIAN PROCEDURE CODE CHANGES
2017 PHYSICIAN PROCEDURE CODE CHANGES Effective for dates of service on or after 1/1/2017, refer to the New Codes listed below for billing. The discontinued codes are not valid for billing dates of service
2018 ASC FINAL Payment Rates
20526 20550 20551 20552 20553 20600 20605 20610 22510 22511 22513 22514 62263 62264 62268 62269 62270 62272 62273 Injection, therapeutic tendon sheath, ligament injection Tendon origin/insertion injection
WELSH INFORMATION GOVERNANCE & STANDARDS BOARD
WELSH INFORMATION GOVERNANCE & STANDARDS BOARD DSC Notice: Date of Issue: 2 nd June 2010 Ministerial / Official Letter: EH/ML/041/09 Subject: NHS Wales Short Stay Surgery Basket of Procedures Sponsor:
New 2010 CPT Codes (italic font represents a new or revised code/description)
New 2010 CPT Codes (italic font represents a new or revised code/description) 14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm 14302 each additional 30.0 sq cm,
Codes for internal or external fixation are to be used only when internal or external fixation is not already listed as part of the basic procedure.
code it HPS Device odes 2015 Reimbursement odes The following codes contained within this document are representative of possible services or diagnoses that may be associated with use of Wright products.
CHAP4-CPTcodes _final doc Revision Date: 1/1/2013
CHAP4-CPTcodes20000-29999_final10312012.doc Revision Date: 1/1/2013 CHAPTER IV SURGERY: MUSCULOSKELETAL SYSTEM CPT CODES 20000-29999 FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES
CHAP4-CPTcodes _final doc Revision Date: 1/1/2015
CHAP4-CPTcodes20000-29999_final10312014.doc Revision Date: 1/1/2015 CHAPTER IV SURGERY: MUSCULOSKELETAL SYSTEM CPT CODES 20000-29999 FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES
Reimbursement Guidelines for Pain Management Procedures 1
GE Healthcare Reimbursement Guidelines for Pain Management Procedures 1 April 2015 www.gehealthcare.com/reimbursement This overview addresses coding, coverage, and payment for pain management procedures
Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatric Surgery. Procedure List. As Of.
Alberta Health Care Insurance Plan Procedure List As Of 01 April 2016 Alberta Health Care Insurance Plan Page i Generated 2016/03/22 TABLE OF CONTENTS As of 2016/04/01 07 PHYSICAL MEDICINE, REHABILITATION,
2019 ASC Proposed Payment Rates
20526 20550 20551 20552 20553 20600 20605 20610 22510 22511 22513 22514 22869 27279 62263 62264 62268 62269 62270 Injection, therapeutic tendon sheath, ligament injection Tendon origin/insertion injection
Issue Number: 0157 Date: 10/01/219
Bulletin Changes to CCSD Schedule of Procedures Issue Number: 0157 Date: 10/01/219 The CCSD has reviewed requests to the CCSD Procedure Schedule for the months of December/January and has agreed on the
Appendix G Day Case and Short Stay Surgery Performance Monitoring. Reference Number: DDCN 2013 / 09
Data Dictionary Change Notice NHS Wales Informatics Service Data Standards Subject(s): Approval Status: Appendix G Day Case and Short Stay Surgery Performance Monitoring This DDCN was approved by the DSCN
2019 ASC FINAL Payment Rates
20526 20550 20551 20552 20553 20600 20605 20610 22510 22511 22513 22514 22869 27279 62263 62264 62268 62269 62270 Injection, therapeutic tendon sheath, ligament injection Tendon origin/insertion injection
2013 FINAL - Physician Payment Rates
ASC/Hospital) Injection, therapeutic (eg, local anesthetic; corticosteroid), 20526 carpal tunnel $74.88 $56.50 $76.55 $56.48 2.2% 0.0% tendon sheath, ligament injection 20550 $57.18 $40.85 $58.52 $41.17
2019 PROPOSED - Physician Payment Rates rates compared to 2018 rates
Injection, therapeutic (eg, local anesthetic; corticosteroid), carpal tunnel 20526 $78.96 $59.58 $79.56 $59.76 $79.30 $59.84-0.3% 0.1% tendon sheath, ligament injection 20550 $53.83 $40.55 $54.36 $40.68
MEDICAL ASSISTANCE BULLETIN
ISSUE DATE August 31, 2015 SUBJECT EFFECTIVE DATE September 1, 2015 MEDICAL ASSISTANCE BULLETIN BY NUMBER 99-15-06 2015 HCPCS Updates and Other Procedure Code Changes Leesa M. Allen, Deputy Secretary IMPORTANT
The number following the procedure code is the TRICARE payment group. EYEBALL
TRICARE/CHAMPUS POLICY MANUAL 6010.47-M S POLICY CHAPTER 13 SECTION 9.1 ADDENDUM 1, SECTION 14 TRICARE-APPROVED AMBULATORY SURGERY S - EYE AND OCULAR ADNEXA The number following the procedure code is the
NOTE: Please append modifier 33 when indicated. If modifier 33 is not appended, regular plan benefits will be applied.
Policy name: Preventive Health Guidelines - Men The following chart contains procedure and diagnosis code combinations that identify services covered under HMSA's Preventive Health s policy. * For professional
CPT COD1NG UPDATES Gastroenterology CPT Advisors
2014 CPT COD1NG UPDATES Gastroenterology CPT Advisors Joel V. Brill, MD, AGA CPT Advisor Daniel C. DeMarco, MD, ACG CPT Advisor Glenn D. Littenberg, MD, ASGE CPT Advisor The American College of Gastroenterology
FY 2017 MCRCEDP Procedure Code Reference Chart
45378-53 45380 45381 45382 45384 45385 48388 45390 ; Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon
The focus of Chapter 9 is on anoscopy, proctosigmoidoscopy, flexible sigmoidoscopy, and colonoscopy procedures and all
9 Anoscopy, 45380 45380 45385 Proctosigmoidoscopy, Flexible Sigmoidoscopy, and Colonoscopy 45378 The focus of Chapter 9 is on anoscopy, proctosigmoidoscopy, flexible sigmoidoscopy, and colonoscopy procedures
Notification of changes to AXA PPP Schedule of Procedures & Fees March 2018
Call our Specialist Fees Team 01892 772160 Mon-Fri 9am-1pm specialistfees@axa-ppp.co.uk We may record and monitor calls for quality assurance, training and as a record of our conversation.. Notification
New World Medical Tourism
Ankle New World Medical Tourism Achilles Repair 7 2 $ 9,805 Brostrum Ligament Reconstruction 6 2 $ 8,850 Arthroscopy Ankle 3 0 $ 6,865 Bilateral Knee Arthroscopy 4 1 $ 8,725 Distal Clavicle Excision 4
Billing Guideline. Subject: Colorectal Cancer Screening Exams (Invasive Procedures) Effective Date: 1/1/14 Last revision effective 4/16
Billing Guideline Subject: Colorectal Cancer Screening Exams (Invasive Procedures) Effective Date: 1/1/14 Last revision effective 4/16 Florida Hospital Care Advantage plans include full coverage of in-network
Nonsurgical Interventional Treatments for Spinal Pain Management
Nonsurgical Interventional Treatments for Spinal Pain Management I. Policy University Health Alliance (UHA) will reimburse for nonsurgical interventional treatment for subacute and chronic spinal pain
2013 MCT CPC-H Quiz #8 Chapters 13 and 14
2013 MCT CPC-H Quiz #8 Chapters 13 and 14 Name: Date: Instructor: Score: 1. A female patient presents to the outpatient clinic for excision of a 4.8 cm malignant melanoma of the left inner thigh. A 6 cm
Spinal Interventional Pain Management and Lumbar Spine Surgery
Spinal Interventional Pain Management and Lumbar Spine Surgery Policy Number: Original Effective Date: MM.06.024 01/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 08/22/2014
DELINEATION OF PRIVILEGES - OPHTHALMOLOGY
KALEIDA HEALTH Name Date DELINEATION OF PRIVILEGES - OPHTHALMOLOGY PLEASE NOTE: Please check the box for each privilege requested. Do not use an arrow or line to make selections. We will return applications
Surgical Privileges Form: Ophthalmology
Surgical Form: Ophthalmology Clinical Request Applicant s Name:. License No. (If Any):... Scope of Practice:. Facility:.. Date:... Category I: CORE PRIVILEGES 1. Admitting privileges 2. Admission history
Morbidity Audit and Logbook Tool SNOMED Board Reporting Terms for SET and IMG Urology ENDOSCOPIC LOWER URINARY TRACT
ENDOSCOPIC LOWER URINARY TRACT Cystolitholapaxy Cystoscopic removal of foreign body from bladder Cystoscopic removal of ureteric stent Cystoscopy and cystodiathermy Cystoscopy and transurethral biopsy
Oregon CPT Preapproval Grid
Not Applicable Home Health Stays - For all Initial Certification and Recertification periods Notes: Initial Certification review required effective 1/1/12. Not Applicable Skilled Nursing Facility Stays
January 31, The services below are being added to the prior authorization list:
January 31, 2019 Effective April 1, 2019, Blue Cross of Idaho is implementing changes to the Commercial and Medicare Advantage prior authorization list for medical and pharmacy services. Prior authorization
Clinical Policy: Monitored Anesthesia Care for Gastrointestinal Endoscopy
Clinical Policy: Monitored Anesthesia Care for Gastrointestinal Endoscopy Reference Number: CP.MP.161 Last Review Date: 05/18 See Important Reminder at the end of this policy for important regulatory and
Foot and Ankle Systems Coding Reference Guide
Foot and Ankle Systems Coding Reference Guide Physician Arthrodesis 27870 Arthrodesis, ankle, open 27871 Arthrodesis, tibiofibular joint, proximal or distal 28705 Arthrodesis; pantalar 28715 Arthrodesis;
POLICY AND PROCEDURE
PAGE: Page 1 of 8 SCOPE: This policy applies to any provider furnishing services represented by Category III CPT codes. PURPOSE & IMPORTANT REMINDER: This policy is current at the time of publication.
CHAP4-CPTcodes _final docx Revision Date: 1/1/2019
CHAP4-CPTcodes20000-29999_final10312018.docx Revision Date: 1/1/2019 CHAPTER IV SURGERY: MUSCULOSKELETAL SYSTEM CPT CODES 20000-29999 FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES
Surgery Center of Oklahoma Pricing Includes Surgeon, Anesthesia, and Facility
Arthroscopy 29871 Knee (Arthroscopy) $3,740.00 29873 Knee with lateral release or microfracture (Arthroscopy) $4,510.00 29806 Shoulder (Arthroscopy) $5,720.00 29830 Elbow (Arthroscopy) $3,740.00 29840
NOTE: Please append modifier 33 when indicated. If modifier 33 is not appended, regular plan benefits will be applied.
Policy name: Health Guidelines - Men This policy applies only to non-grandfathered plans as defined in the Affordable Care Act section 1251. The following chart contains procedure, diagnosis and modifier
2016 CPT coding changes and their effects
18 2016 CPT coding changes and their effects by Linda Barney, MD, FACS, and Mark T. Savarise, MD, FACS Significant Current Procedural Terminology (CPT)* coding changes are being implemented in 2016. Notably,
2016 MEDICARE PHYSICIAN & FACILITY REIMBURSEMENT INFORMATION*
2016 MEDICARE & FACILITY REIMBURSEMENT INFORMATION* CODING FOR CLARIX PRODUCTS UTILIZED AS SURGICAL COVERINGS, WRAPS OR BARRIERS CLARIX CORD 1K, CLARIX 100 and CLARIX FLO are cryopreserved human umbilical
Spinal and Trigger Point Injections
Spinal and Trigger Point Injections I. Policy University Health Alliance (UHA) will reimburse for nonsurgical interventional treatment for subacute and chronic spinal pain when determined to be medically
MP.090.MH Nerve Block, Paravertebral, Facet Joint, and SI Injections
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.090.MH Nerve Block, Paravertebral, Facet Joint, and SI This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP
! " " # $ " " # $ " % " # $ # $
! " "#$ " "#$ " % "# $ #$ Skin Replacement Surgery Grafts 15040 Harvest of skin for cultured autograft 100 sq cm or less 15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or 1% of children
code it ACTISHIELD HCPCS Device Codes Amniotic Barrier Membrane HCPCS Code C9399 Description Q4100 C5271
code it HCPCS Device Codes 2015 Reimbursement Codes The following codes contained within this document are representative of possible services or diagnoses that may be associated with use of Wright products.
Program= Loma Linda University Program
OPHTHALMOLOGY: PROGRAM REPORT (Main Table) Reporting Period: Total Experience of Residents Completing rams in 2008-2009 ram=2400521023 - Loma Linda University ram [PART 1 ] rams in the Nation: 115 Residents
The 2017 No Authorization Required. Out-Patient List of Surgical CPT Codes
The 2017 No Authorization Required Out-Patient List of Surgical CPT s Please note: All Medicare members must have a referral issued by their PCP to see most Specialists. Out of Network Providers: Please
2012 FITWAY Allowable CPT Codes (Modifiers are to be reported with appropriate CPT codes at the discretion of the Provider or Facility)
2012 FITWAY Allowable s (Modifiers are to be reported with appropriate CPT codes at the discretion of the Provider or Facility) Fecal Immunochemical Test (FIT) G0328/ 82274 Colorectal cancer screening
2017 Procedural Reimbursement Guide for Endoscopy
2017 Procedural Reimbursement Guide for Endoscopy THIS PROCEDURAL REIMBURSEMENT GUIDE, FOR SELECT ENDOSCOPY PROCEDURES, provides coding and reimbursement information for physicians and facilities. The
Room and Board - Per Day Charges
At Augusta University Health System, we strive to provide the information you need to understand every aspect of your care. In keeping with this promise, AUHS is providing this price list for our services.
SENARAI KADAR CAJ YANG TELAH MENDAPAT KELULUSAN ( JABATAN OFTALMOLOGI )
SENARAI KADAR CAJ YANG TELAH MENDAPAT KELULUSAN ( JABATAN OFTALMOLOGI ) PTJ : JK.55 : JABATAN OFTALMOLOGI (JOFT) Sub PTJ : JK.55.01 : AM No Item Code / Name 1 1674 11674 - ANTERIOR CHAMBER WASHOUT 95.00
Codes for Back and Spinal Procedures
20930 Allograft for spine surgery only; morselized 20931 Allograft for spine surgery only; structural 20936 Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process,
ABOS/CORD Surgical Skills Assessment Program
American Board of Orthopaedic Surgery Establishing Education & Performance Standards for Orthopaedic Surgeons ABOS/CORD Surgical Skills Assessment Program ABOS Essential Knowledge, Skills, and Behaviors
A B C Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less $ 772
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 CPT PROCEDURES DESC HCPCS/CPT BCH BASE 10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or
MyCare Advisor is our online suite of tools that assist Members in understanding and comparing cost, quality, and satisfaction among Providers.
January 2012 What is MyCare Advisor SM? Thinking about health care services in a different light is the first step to educating yourself on health care costs. Capital BlueCross is taking the second step
Expert Consensus Decision Pathway on Peri- Procedural Management of Anticoagulation
Expert Consensus Decision Pathway on Peri- Procedural Management of Anticoagulation John U Doherty, MD, FACC Anticoagulation Consortium Roundtable Heart House October 24, 2015 Peri-Procedural Management
PERCUTANEOUS FACET JOINT DENERVATION
Status Active Medical and Behavioral Health Policy Section: Surgery Policy Number: IV-95 Effective Date: 10/22/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members should
Stone Management Coding & Payment Quick Reference
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. The coding options listed within this guide are commonly used codes
C ODING PAIN C LINICS. After attending this presentation, attendee will be able to: Coding Check List
Home Town Health Take the Pain out of Coding Pain Clinics J E NAN C U S TER C P C, C C S, C D I P AH IMA A PPROVED IC D - 1 0 - C M/PC S T RAINER AND A MBASSADOR D IRECTOR OF C ODING H EALTHCARE C ODING
Defining Non-Compounded Sclerotherapy
Defining Non-Compounded Sclerotherapy December 14, 2017 I m not sure I understand the new vein surgery codes in the 2018 CPT manual. Can you explain what non- compounded means? The new 2018 coded, 36465,
OUTPATIENT SERVICES PRIOR AUTHORIZATION LIST - CONNECTICUT MEDICARE APRIL 2012
The information contained in this listing pertains to Wellcare of Connecticut Medicare authorization requirements only. The codes contained on this list are limited to Current Procedural Terminology (CPT
1105 two (2) vertebrae... 1, add on per additional vertebra
SPINE STAGE OPERATIONS Staged operations shall be paid at 100% for the first stage and 85% for the second stage. Where the second stage pays a higher fee 100% shall be paid and the first stage shall be
99202 Office visit new patient, problem expanded $ Smoking and tobacco use cessation counseling visit $37.30
MILBRIDGE MEDICAL CENTER FAMILY PRACTICE 24 SCHOOL ST, MILBRIDGE ME 99202 Office visit new patient, problem expanded $140.90 99406 Smoking and tobacco use cessation counseling visit $37.30 99397 Preventive
b) In each case, can you please tell me the sum paid and a description of the additional work it was paid for?
Ref: FOI/CAD/ID 2673 27 May 2016 Please reply to: FOI Administrator Trust Management Service Centre Maidstone Hospital Hermitage Lane Maidstone Kent ME16 9QQ Email: mtw-tr.foiadmin@nhs.net Freedom of Information
CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE
CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE Phone: 800-609-1108 Email: codmanpump@aol.com Fax: 303-703-1572
Coding Hot Topics. Lawrence A. Santi, DPM, FASPS Member, APMA Coding Committee
Coding Hot Topics Lawrence A. Santi, DPM, FASPS Member, APMA Coding Committee 1 Disclaimer Participants in the APMA Coding Webinar are reminded that CPT code descriptors and coding policies do not reflect
Subcutaneous Tissues
Podiatry Fee Schedule Effective January 1, 2013 The Base Fee listed below for each code is reimbursement for services rendered to adult recipients age 21 and over. To calculate the fee for children under
Anesthesia Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes
Anesthesia Cross Coder Essential links from CPT codes to ICD-9-CM and HCPCS codes 2015 Contents Introduction... i CPT Anesthesia to Procedure Crosswalk...i Format...i Icon Key...ii CPT Codes...ii Resequenced
The Orthopaedic Coding Coach 2010 Orthopaedic Coding Tips By Karen Zupko & Associates
The Orthopaedic Coding Coach 2010 Orthopaedic Coding Tips By Karen Zupko & Associates Use of Modifiers October 14, 2010 I was recently told that when applying more than one modifier, they should be listed
Sage Program Reimbursement Rates (Effective Jan 1, 2018 through Dec 31, 2018)
Sage Program Reimbursement Rates Code Description of Service Allowable Rates New Patient 99201 History, exam, straight forward decision-making; 10 $44.47 99202 Expanded history; exam, straightforward decision-making;
MEDICAL HISTORY CHIRO PHYSICAL
Overview of Spinal Injection Procedures Blake A. Johnson, MD, FACR 1 PATIENT MANAGEMENT EVALUATION TREATMENT P.T. MEDICAL CHIRO S SURGICAL Effective treatment requires a precise diagnosis! HISTORY PHYSICAL
AMA/Specialty Society Relative Value Update Committee (RUC) Final Vote Release CPT 2016
AMA/ Society Relative Value Update Committee () Vote Release 2016 Every year, the holds three meeting to review codes that are either new, revised or considered potentially misvalued by either the Centers