Ancillary Services. Agenda. Jacqueline J. Stack, BSHA, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC

Size: px
Start display at page:

Download "Ancillary Services. Agenda. Jacqueline J. Stack, BSHA, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC"

Transcription

1 Ancillary Services Jacqueline J. Stack, BSHA, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC 1 Agenda What are ancillary services? Pulmonary Function Testing Stress Testing Radiology Ultrasounds In-house Labs Weight management Infusion therapy Trigger point injections Joint injections Therapy 2 1

2 Requirements Orders Medical Necessity Results Interpretation Advance Beneficiary Notice 3 Pulmonary Function Testing Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation Bronchodilation responsiveness, sprioromety as in pre- and postbronchodilator administration 4 2

3 Pulmonary Function Testing Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies or materials provided) 5 Example A 65 year old patient comes into your office today with an exacerbation of his COPD. The physician treats the patient and asks the patient to come back into the office in a week for a spriometry test. He asks the patient to bring his bronchodilator (inhaler) with him for a pre and post test. The patient will follow up in 2 weeks. 6 3

4 Electrocardiogram Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report tracing only, without interpretation and report interpretation and report only 7 Example A 40 year old patient comes in with chest pain that she has had off an on for the past couple of days. The physician gets a ECG while the patient is in the office. The physician also reads the ECG and documents his interpretation. 8 4

5 Stress Testing Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report 9 Stress Testing physician supervision only, without interpretation and report tracing only, without interpretation and report interpretation and report only 10 5

6 Echocardiography Transthoracic echocardiography for congenital cardiac anomalies; complete follow-up or limited study 11 Echocardiography Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete with spectral Doppler echocardiography, and with color flow Doppler echocardiography 12 6

7 Echocardiography Echocardiography, transthoracic, real-time with image documentation (2D) includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography 13 Echocardiography Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study 14 7

8 Example A 50 year old patient is referred to a cardiologist for some intermittent chest pain and shortness of breath. The cardiologist evaluates the patient and orders a stress test and echocardiogram. These tests are performed in the office on the same day and the cardiologist supervises the tests, interprets and documents the report. 15 Arterial Duplex Scan Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study unilateral or limited study Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study unilateral or limited study 16 8

9 Carotid Duplex Scan Duplex scan of extracranial arteries; complete bilateral study unilateral or limited study 17 Venous Duplex Studies Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study unilateral or limited study 18 9

10 Example A patient comes in for pain in their left lower leg. After a examination by the physician a venous duplex study was ordered and performed. 19 Aortic Ultrasound Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study unilateral or limited study 20 10

11 Renal Artery Ultrasound Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study limited study 21 Ultrasound Ultrasound, pregnant uterus, real time with documentation fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation each additional gestation 22 11

12 Ultrasound Ultrasound, pregnant uterus, real time with image documentation fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation each additional gestation 23 Ultrasound Ultrasound pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation each additional gestation 24 12

13 Ultrasound Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single for first gestation each additional gestation 25 Ultrasound Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal hart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses 26 13

14 Ultrasound Ultrasound, pregnant uterus,, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus 27 Radiology Abdomen Ankle Arm, upper Arm, lower Chest Clavicle Elbow 28 14

15 Radiology Femur Fibula Finger Foot Hand Heel Hip Humerus 29 Radiology Knee Leg Neck Ribs , Shoulder Sinuses Tibia Toe 30 15

16 Example A 75 year old patient comes into your office following a fall. The patient is having some right leg, right hip pain and right shoulder pain. The provider orders a x-ray on the patients right hip, leg and shoulder. 31 Laboratory Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy Urine pregnancy test, by visual color comparison methods 32 16

17 Laboratory Prothrombin time Blood, occult, by peroxidase activity (eg. guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection) 33 Laboratory Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use Rapid streptococcus, group A 34 17

18 85025 CBC Laboratory Basic Metabolic Panel Electrolyte Panel Urinalysis, automated with microscopy Calcium; total Carbon Dioxide (bicarbonate) Creatinine; blood 35 Laboratory Hemoglobin, glycosylated (A1C) Lead Sedimentation rate, erythrocyte; non-automated Lipid panel Thyroid stimulating hormone (TSH) 36 18

19 Laboratory Prostate specific antigen (PSA); complexed (direct measurement) total free 37 Example A 50 year old male patient comes in today with a laboratory requisition. The laboratory tests that are performed today are: CBC Urinalysis Lipid panel Basic Metabolic Panel PSA 38 19

20 Education Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes intensive, greater than 10 minutes HCPCS Level II Codes: G Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes G0437- intensive, greater than10 minutes 39 Weight Management Evaluation and management codes Preventive medicine counseling and/or risk factor reduction intervention (s) provided to an individual (separate procedure); approximately 15 minutes approximately 30 minutes approximately 45 minutes approximately 60 minutes 40 20

21 Medical Nutritional Therapy Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes re-assessment and intervention, individual, face to face with the patient, each 15 minutes group (2 or more individual(s)), each 30 minutes 41 Osteopathic Manipulative Treatment Osteopathic manipulative treatment (OMT); 1-2 body regions involved body regions involved body regions involved body regions involved body regions involved 42 21

22 Example A 33 year old patient comes into the office with some neck pain. The physician, who is a DO examines the patient and makes the decision to perform a OMT treatment in 3 body regions. 43 Trigger Point Injections Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) single or multiple trigger point(s); 3 or more muscle(s) 44 22

23 Joint Injections Arthrocentesis aspiration and/or injection; small joint or bursa (eg. fingers, toes) intermediate joint or bursa (eg. Temporomandibular, acromioclavicular,, wrist, elbow or ankle, olecranon bursa) major joint or bursa (eg. Shoulder, hip, knee joint, subacromial bursa) 45 Example A 42 year old female patient comes into the office for left shoulder pain. After examination of the patient the physician makes the decision that he will inject the patients left shoulder joint

24 Infusion Therapy Intravenous infusion, for therapy, prophylaxis, or diagnosis(specify substance or drug); initial, up to 1hour each additional hour additional sequential infusion up 1 hour concurrent infusion 47 Infusion Therapy Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump each additional hour additional pump set-up with establishment of new subcutaneous infusion site(s) 48 24

25 Infusion Therapy Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular intra-arterial intravenous push, single or initial substance/drug each additional sequential intravenous push of a new substance/drug each additional sequential intravenous push of the same substance/drug provided in a facility 49 Physical and Occupational Therapy Physical therapy evaluation Physical therapy re-evaluation Occupational therapy evaluation Occupational therapy reevaluation 50 25

26 Modalities Application of a modality to 1 or more areas; hot or cold pack traction, mechanical electrical stimulation (unattended) vasopneumatic devices whirlpool 51 Therapeutic Procedures Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities 52 26

27 Therapeutic Procedures aquatic therapy with therapeutic exercises gait training (includes stair climbing) massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion) 53 Example A patient comes in for low back pain. The physical therapist evaluates the patient he determines that the patients therapy will include application of hot pack and electrical stimulation 3 times a week for the next 3 weeks and does the first treatment today

28 Thank You 55 28

Radiological / Imaging Services Fee Schedule Provider Specialty 093

Radiological / Imaging Services Fee Schedule Provider Specialty 093 CODE MOD Description 70250 TC RADIOLOGIC EXAM SKULL $18.30 $18.30 7/1/2012 71010 TC RADIOLOGIC EXAM, CHEST $11.41 $11.41 7/1/2012 71020 TC RADILOGICAL EXAM CHEST TWO VIEWS FRONTAL/LATERAL $15.76 $15.76

More information

Sutter Health Plus Effective for Calendar Year 2015

Sutter Health Plus Effective for Calendar Year 2015 Sutter Health Plus Effective for Calendar Year 2015 CPTs CPT Descriptions 2015 Cost Under Deducible (Single Unit) Doctor's Office Visit for a New Patient (Also Urgent Care) 99201 Low Level Visit $99.00

More information

2017 Patient Pricelist

2017 Patient Pricelist 2017 Patient Pricelist Attached are the most frequent charges at St. Elizabeth Healthcare. All patients are charged the same irrespective of one s ability to pay. The patient s responsibility may vary

More information

Medica Health Plans. Minnesota Fee Schedule Revised 5/1/2016 NEW PATIENT EXAMS: MN Medicaid. Medicare

Medica Health Plans. Minnesota Fee Schedule Revised 5/1/2016 NEW PATIENT EXAMS: MN Medicaid. Medicare Medica Health Plans Minnesota Fee Schedule Revised 5/1/2016 NEW PATIENT EXAMS: 99201 Problem focused history and examination --straightforward $23.48 100% of CMS $29.53 99201.25 Problem focused history

More information

Managed Physical Network, Inc.

Managed Physical Network, Inc. MPN DC FEE SCHEDULE EVALUATION AND MANAGEMENT 99201 New Patient Exam; Problem Focused $50.00 99202 New Patient Exam; Expanded $50.00 99203 New Patient Exam; Detailed $50.00 99204 New Patient Exam; Comprehensive

More information

INDIANA HEALTH COVERAGE PROGRAMS

INDIANA HEALTH COVERAGE PROGRAMS INDIANA HEALTH COVERAGE PROGRAMS PROVIDER CODE TABLES Medical Review Team s Due to possible changes in Indiana Health Coverage Programs (IHCP) policy or national coding updates, inclusion of a code on

More information

Codes Requiring Authorization from MedSolutions (MSI): Updated 3/2014

Codes Requiring Authorization from MedSolutions (MSI): Updated 3/2014 s Requiring Authorization from MedSolutions (): Updated 3/2014 0042T Cerebral Perfusion Analysis using CT with contrast 0159T CAD, including computer algorithm analysis, BREAST MRI 0195T prepare interspace,

More information

Tufts Health Plan Imaging Privileging Program

Tufts Health Plan Imaging Privileging Program Tufts Health Plan Imaging Privileging Program The Commercial Provider Manual applies to Commercial 1 Plan). products (including Tufts Health Freedom Imaging Privileges for Nonradiologists The Tufts Health

More information

2017 Spring Convention

2017 Spring Convention 2017 Spring Convention CPT Coding & Modifiers Paul Andrews Please scan IN at the start of class Please scan OUT at the end of class You must attend the entire session to earn your credit(s) for this class

More information

Physical Therapy. Physical Therapy Payment Policy Page 1

Physical Therapy. Physical Therapy Payment Policy Page 1 Physical Therapy I. Policy University Health Alliance (UHA) will reimburse for physical therapy when it is determined to be medically necessary and when it meets the medical criteria guidelines (subject

More information

Cigna - Prior Authorization Procedure List Cardiology

Cigna - Prior Authorization Procedure List Cardiology Cigna - Prior Authorization Procedure List Cardiology Category CPT Code CPT Code Description 33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial 33207 Insertion

More information

Anthem Central Region Clinical Claims Edit

Anthem Central Region Clinical Claims Edit Please compare the claim's date of adjudication to the range of the edit in question. Prior versions, if any, can be found below. Subject: Different Services with Anesthesia Services Edit #785 Effective

More information

Concord Hospital Cost of Care Estimates

Concord Hospital Cost of Care Estimates Hospital Departments Laboratory Services Basic Metabolic Panel (BMP)(80048) $88 N/A $88 $35 Blood draw (36415) $29 N/A $29 $12 Complete blood cell count (CBC)(85025) $88 N/A $88 $35 Comprehensive Metabolic

More information

Patient Price Information List January 1, 2018

Patient Price Information List January 1, 2018 In compliance with state law, Western Reserve Hospital is providing this price list containing our charges for Room and Board, Emergency Department, Operating Room, Physical Therapy, Pain Medicine and

More information

Hospital Charge Information List

Hospital Charge Information List Hospital Charge Information List To better inform our patients, Norton Healthcare has prepared the following price list of our charges for some of the more common reasons for a hospital visit. They include

More information

Occupational Therapy. Occupational Therapy Payment Policy Page 1

Occupational Therapy. Occupational Therapy Payment Policy Page 1 Occupational Therapy I. Policy Occupational therapy is a form of rehabilitation therapy involving the treatment of neuromusculoskeletal function through the use of specific tasks or goal-directed activities

More information

Specialty UM Pre-Authorization Program Program Code Listing Texas Medicare Last Updated: February 21, 2017

Specialty UM Pre-Authorization Program Program Code Listing Texas Medicare Last Updated: February 21, 2017 A-1 Radiology Code Code Description 70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) 70450 Computed tomography, head or brain; without contrast material 70460 Computed tomography,

More information

Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Procedures 1 Performed by Emergency Medicine Physicians

Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Procedures 1 Performed by Emergency Medicine Physicians GE Healthcare Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Procedures 1 Performed by Emergency Medicine Physicians January, 2013 www.gehealthcare.com/reimbursement This overview

More information

CPT CODES. Ph: (307) Fax: (307) CATSCAN IV Contrast: 87.00

CPT CODES. Ph: (307) Fax: (307) CATSCAN IV Contrast: 87.00 Ph: (307) 382-4282 Fax: (307) 382-4291 CPT CODES CATSCAN IV Contrast: 87.00 74150 Abdomen w/o contrast $ 809.00 74160 Abdomen w/ contrast $1175.00 w/ contrast: $1262.00 74170 Abdomen w_w/o contrast $1324.00

More information

Payment Policy. Chiropractic Care. Policy Specific Section: September 10, 2012 November 10, 2012

Payment Policy. Chiropractic Care. Policy Specific Section: September 10, 2012 November 10, 2012 Payment Policy Chiropractic Care Type: Payment Policy Policy Specific Section: Payment Original Policy Date: Effective Date: September 10, 2012 November 10, 2012 Description Chiropractic is a branch of

More information

The number of Chiropractic visits allowed per year may vary according to the member s specific benefit.

The number of Chiropractic visits allowed per year may vary according to the member s specific benefit. Payment Policy Chiropractic Services EFFECTIVE DATE:07 21 2009 POLICY LAST UPDATED: 04 17 2018 OVERVIEW Chiropractic is a healthcare profession that focus on disorders of the musculoskeletal and nervous

More information

Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014

Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014 Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014 1. Tables 1 through 4 identify the procedure codes that should be billed to the Indiana Health Coverage Programs (IHCP)

More information

Patient Price Information List

Patient Price Information List Patient Price Information List In compliance with state law, Wayne HealthCare is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical

More information

HIP RADIOLOGY PROGRAM CODE LISTS

HIP RADIOLOGY PROGRAM CODE LISTS EFFECTIVE OCTOBER 1, 2012 70336 MAGNETIC RESONANCE IMAGING TMJ 70450 COMPUTED TOMOGRAPHY HEAD/BRAIN WITHOUT 70460 COMPUTED TOMOGRAPHY HEAD/BRAIN WITH 70470 COMPUTED TOMOGRAPHY HEAD/BRAIN WITHOUT AND WITH

More information

CONSUMER PRICE GUIDE

CONSUMER PRICE GUIDE 1 CONSUMER PRICE GUIDE Revised January 1 st 2017 General Information Memorial Hospital abides by all state and federal charging and billing regulations for hospital based healthcare services. The following

More information

Procedure code billed is not approved for the therapy/pathology assistant.

Procedure code billed is not approved for the therapy/pathology assistant. ATTENTION: Provider Business Office Managers and Medicaid Billers Billing for Services of a Physical Therapy, Occupational Therapy or Speech-Language Pathology Assistant Effective on and after August 7,

More information

Patient Price Information List

Patient Price Information List Patient Price Information List In compliance with state law, Morrow County Hospital is providing this price list containing our charges for room and board, Emergency Department, operating room, physical

More information

Physical Therapy MM /15/2003

Physical Therapy MM /15/2003 Physical Therapy Policy Number: Original Effective Date: MM.09.005 07/15/2003 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 06/23/2017 Line(s) of Business Excluded: Federal Employee

More information

Eastern Maine Medical Center Patient Price Information Effective October 1, 2017 September 30, 2018

Eastern Maine Medical Center Patient Price Information Effective October 1, 2017 September 30, 2018 Eastern Maine Medical Center Patient Price Information Effective October 1, 2017 September 30, 2018 To help our patients make informed health care decisions, Eastern Maine Medical Center has provided pricing

More information

Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Vascular Procedures 1

Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Vascular Procedures 1 GE Healthcare Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Vascular Procedures 1 January, 2013 www.gehealthcare.com/reimbursement This overview addresses coding, coverage,

More information

Medical Necessity Guidelines: Outpatient Physical Therapy, Occupational Therapy and Speech Therapy

Medical Necessity Guidelines: Outpatient Physical Therapy, Occupational Therapy and Speech Therapy Medical Necessity Guidelines: Outpatient Physical Therapy, Occupational Effective: January 1, 2018 Clinical Documentation and Prior Authorization Required Applies to: 2273290 1 Outpatient Physical, Occupational

More information

Timed Therapeutic Procedures

Timed Therapeutic Procedures Timed Therapeutic Procedures Policy Number: 10.01.526 Last Review: 4/2014 Origination: 4/2009 Next Review: 4/2015 Policy Documentation to support the reporting of timed procedure codes is required. The

More information

M.D.IPA, M.D.IPA Preferred, Optimum Choice and Optimum Choice Preferred STAT Laboratory List Revised Jan. 5, 2017

M.D.IPA, M.D.IPA Preferred, Optimum Choice and Optimum Choice Preferred STAT Laboratory List Revised Jan. 5, 2017 M.D.IPA, M.D.IPA Preferred, Optimum Choice and Optimum Choice Preferred STAT Laboratory List Revised Jan. 5, 2017 If laboratory results are required on a STAT basis, the designated commercial medical laboratory

More information

Kaiser Permanente 2015 Sample Fee List 1

Kaiser Permanente 2015 Sample Fee List 1 Kaiser Permanente 2015 Sample Fee List 1 SOUTHERN CALIFORNIA Knowing how much you can expect to pay for care and services can give you peace of mind. This Sample Fee List shows you estimated charges for

More information

INDIANA HEALTH COVERAGE PROGRAMS

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

More information

Final MPFS 2014 Summary SIR

Final MPFS 2014 Summary SIR Final MPFS 2014 Summary SIR The CY 2014 PFS CF is $27.2006 (p531) Impact Tables (p1285) Refinement Panel Recommendations (p183) Table 23 presents information on the work RVUs for the codes considered by

More information

Kaiser Permanente 2012 Sample Fee List Members in any deductible plan 1 can use this list to help estimate their charges.

Kaiser Permanente 2012 Sample Fee List Members in any deductible plan 1 can use this list to help estimate their charges. Kaiser Permanente 2012 Sample Fee List Members in any deductible plan 1 can use this list to help estimate their charges. NORTHERN CALIFORNIA As your partner in health, we want to help you manage your

More information

Kaiser Permanente 2013 Sample Fee List

Kaiser Permanente 2013 Sample Fee List Kaiser Permanente 2013 Sample Fee List Members in any deductible plan 1 can use this list to help estimate their charges. COLORADO As your partner in health, we want to help you manage your health care

More information

LABORATORY PROCEDURES IMAGING/RADIOLOGY PROCEDURES THERAPY GVH EMERGENCY DEPARTMENT PROCECURES

LABORATORY PROCEDURES IMAGING/RADIOLOGY PROCEDURES THERAPY GVH EMERGENCY DEPARTMENT PROCECURES PROCEDURE CHARGES / HOSPITAL may vary depending on circumstances. Prices subject to change. LABORATORY PROCEDURES Basic Metabolic Panel $112.00 80048 Comprehensive Metabolic Panel $140.00 80053 UA Micro

More information

73725x2 MRA Pelvis Runoff (to ankle) CTA Abdomen with & without CTA Cardiac Brain without 70551

73725x2 MRA Pelvis Runoff (to ankle) CTA Abdomen with & without CTA Cardiac Brain without 70551 CT CT Myelogram MRI Abdomen without 74150 Cervical 62302 Abdomen / MRCP 74181 Abdomen with 74160 Thoracic 62303 Abdomen / MRCP with & without 74183 Abdomen with & without 74170 Lumbar 62304 Abdomen / Pelvis

More information

We Accept Care Credit

We Accept Care Credit We Accept Care Credit Standard Fee Schedule Valid 1-Jan-18 to 1-July-18 **Prices Subject to Change, Call 702-222-3544 For Verification** Exam CPT PAYMENT IN FULL AT TIME OF SERVICE EKG 93000 35 TREADMILL

More information

Fidelis Care: Cardiology, Radiology, and Ultrasound CPT Code List

Fidelis Care: Cardiology, Radiology, and Ultrasound CPT Code List Fidelis Care: Cardiology, Radiology, and Ultrasound CPT Code List CPT Code CPT Code Description Requires PA 75557 Cardiac magnetic resonance imaging for morphology and function without contrast material

More information

CPT Code Details

CPT Code Details CPT Code 93925 Details Code Descriptor Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Lay Term The provider performs a duplex ultrasound scan of the lower extremity

More information

Sage Program Reimbursement Rates (Effective Jan 1, 2018 through Dec 31, 2018)

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;

More information

The Human Body. Lesson Goal. Lesson Objectives 9/10/2012. Provide a brief overview of body systems, anatomy, physiology, and topographic anatomy

The Human Body. Lesson Goal. Lesson Objectives 9/10/2012. Provide a brief overview of body systems, anatomy, physiology, and topographic anatomy The Human Body Lesson Goal Provide a brief overview of body systems, anatomy, physiology, and topographic anatomy Medial Lateral Proximal Distal Superior Inferior Anterior Lesson Objectives Explain the

More information

2013 Coding Changes. Diagnostic Radiology. Nuclear Medicine

2013 Coding Changes. Diagnostic Radiology. Nuclear Medicine 2013 Coding Changes The principal coding changes affecting Radiologists in 2013 occur in the Interventional Radiology Section of the AMA/CPT Manual. As in the past, we continue to see the Relative Update

More information

Patient Price Information List

Patient Price Information List In compliance with federal law, Bradford Regional Medical Center is providing this price list containing our room and board, inpatient service, emergency room, operating room, physical therapy and other

More information

Diagnostic Imaging Prior Review Code List 2 nd Quarter 2018

Diagnostic Imaging Prior Review Code List 2 nd Quarter 2018 Computerized Tomography (CT) Abdomen 6 Abdomen/Pelvis Combination 101 Service 74150 CT abdomen; w/o 74160 CT abdomen; with 74170 CT abdomen; w/o followed by 74176 Computed tomography, abdomen and pelvis;

More information

Services that May be Referred by a Nurse Practitioner INJECTION, VENEPUNCTURE CONSULTATION IN OFFICE AGE ( 2-59) GP ECG

Services that May be Referred by a Nurse Practitioner INJECTION, VENEPUNCTURE CONSULTATION IN OFFICE AGE ( 2-59) GP ECG Services that May be Referred by a Nurse Practitioner 00012 INJECTION, VENEPUNCTURE 00110 CONSULTATION IN OFFICE AGE ( 2-59) GP 00117 ECG INTERPRETATION ONLY GP 00204 DIRECTIVE CARE BY CONSULTANTS, DERMATOLOGY

More information

INDIANA HEALTH COVERAGE PROGRAMS

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

More information

Cigna - Prior Authorization Procedure List: Radiology & Cardiology

Cigna - Prior Authorization Procedure List: Radiology & Cardiology Cigna - Prior Authorization Procedure List: Radiology & Cardiology Product Category CPT Code CPT Code Description Radiology MR 70336 MRI Temporomandibular Joint(s), (TMJ) Radiology CT 70450 CT Head or

More information

In-OfficeLabTesting. Effective date: August 1, 2017

In-OfficeLabTesting. Effective date: August 1, 2017 Effective date: August 1, 2017 In-OfficeLabTesting The lab services below can be performed and reimbursed in an office setting. All other office-based lab services must be submitted through our contracted

More information

Physical Medicine & Rehabilitation: Maximum Combined Frequency per Day Policy

Physical Medicine & Rehabilitation: Maximum Combined Frequency per Day Policy Policy Number Physical Medicine & Rehabilitation: Maximum Combined Frequency per Day Policy 2017R0101E Annual Approval Date 7/13/2016 Approved By Payment Policy Oversight Committee IMPORTANT NOTE ABOUT

More information

bilateral, both before below elbow twice a day below knee bedrest

bilateral, both before below elbow twice a day below knee bedrest Abbreviations Student Name: A approximately assessment assist active active assist abdominal aortic aneurysm active assistive range of motion abduction/adduction acromioclavicular joint anterior cruciate

More information

Room and Board Per Day Charges

Room and Board Per Day Charges In compliance with state law, Olean General Hospital is providing this price list containing our room and board, inpatient service, emergency room, operating room, physical therapy and other procedures.

More information

In Office Lab Testing

In Office Lab Testing Effective January 1, 201, the lab services below can be performed and reimbursed in an office setting. All other office-based lab services must be submitted through our contracted laboratory providers.

More information

SoonerCare Fax Blast

SoonerCare Fax Blast SoonerCare Fax Blast February 15, 2008 Subject: EPSDT and 4 th DPT/DTaP Encounters Dear Provider: Please note the following: EPSDT All encounters for EPSDT for 2007 dates of service must be filed before

More information

EXAMS_ Page 1/5 SORTED - NUMERIC

EXAMS_ Page 1/5 SORTED - NUMERIC BIOPSY 19103L-MR MV MR Guided Breast Biopsy, Vac Assist - LT 19103, 77021, 10022, 19295, 90772, A4550, 99000 19103L-ST MV Stereotactic Breast Biopsy, Vac Assist - LT 19103, 77031, 10022, 19295, 90772,

More information

Sunnyview Rehabilitation Hospital

Sunnyview Rehabilitation Hospital Sunnyview Rehabilitation Hospital The below charges represent Hospital charges only. These charges do not include charges for services provided by physicians or advanced practitioners (ex. anesthesiologists,

More information

Jun 15, CPT codes and are assigned for bilateral upper or lower extremity arterial assessments to check blood flow in relation to a

Jun 15, CPT codes and are assigned for bilateral upper or lower extremity arterial assessments to check blood flow in relation to a Jun 15, 2009. CPT codes 93922 and 93923 are assigned for bilateral upper or lower extremity arterial assessments to check blood flow in relation to a blockage.. 93922 Noninvasive physiologic studies of

More information

Anthem Blue Cross and Blue Shield Virginia Advanced Imaging Procedures Requiring Precertification Revised 02/13/2013

Anthem Blue Cross and Blue Shield Virginia Advanced Imaging Procedures Requiring Precertification Revised 02/13/2013 Anthem Blue Cross and Blue Shield Virginia Advanced Imaging Procedures Requiring Precertification Revised 02/13/2013 Modality and CT Head CTA Head: Cerebrovascular MRI Head MRA Head: Cerebrovascular Functional

More information

Icd 10 code bilateral ankle swelling with pain

Icd 10 code bilateral ankle swelling with pain Icd 10 code bilateral ankle swelling with pain The Borg System is 100 % Icd 10 code bilateral ankle swelling with pain Pelvic/perineal pain : Ganglion impar blocks of the sacrococcygeal joint are considered

More information

2014 CPT Radiology Codes Requiring Review

2014 CPT Radiology Codes Requiring Review CT Head 1 70480 CT orbit, sella or posterior fossa; w/o contrast 1 CT Head 1 70481 CT orbit, sella or posterior fossa; with CT orbit, sella or posterior fossa; w/o contrast CT Head 1 70482 followed by

More information

Guide to Cardiology Care at Scripps

Guide to Cardiology Care at Scripps Guide to Cardiology Care at Scripps Cardiology is the word in health care associated with heart, but the body s vascular system is also an important part of heart care. Your body has more than 60,000 miles

More information

Last Updated: 2/10/2017 Implementation date: 4/3/2017 Radiology & Cardiology Prior Authorization / Utilization Management Procedure List

Last Updated: 2/10/2017 Implementation date: 4/3/2017 Radiology & Cardiology Prior Authorization / Utilization Management Procedure List Last Updated: 2/10/2017 Implementation date: 4/3/2017 Radiology & Cardiology Prior Authorization / Utilization Management Procedure List Deal Sheet Group Product Category CPT CPT Description 3D Imaging

More information

screening; including image post processing CT, heart; without contrast material; with Requires authorization

screening; including image post processing CT, heart; without contrast material; with Requires authorization 0042T Cerebral perfusion analysis using CT; with ; including of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time 74263 Computed tomographic (CT) colonography,

More information

Summa Barberton Hospital Usual and Customary Charges for Selected Procedures Patient Price List

Summa Barberton Hospital Usual and Customary Charges for Selected Procedures Patient Price List In compliance with state law, Summa Barberton Hospital publishes charges for room and board, emergency department, labor and delivery, operating room, lab, radiology and other procedures. This publication

More information

STREAM. Human Body Project Pages Website QR Code body project/

STREAM. Human Body Project Pages Website QR Code   body project/ STREAM Human Body Project Pages 1 16 Website QR Code https://sites.google.com/a/wyckoffschools.org/human body project/ Project Checklist Did you include Head a brain that can open to show the inside as

More information

UnitedHealthcare, UnitedHealthcare of the River Valley and Neighborhood Health Partnership Cardiology Notification and Prior Authorization Program:

UnitedHealthcare, UnitedHealthcare of the River Valley and Neighborhood Health Partnership Cardiology Notification and Prior Authorization Program: Notification and Prior Authorization Program: Electrophysiology Implant Classification Table The following chart contains the codes that require notification or prior authorization as part of UnitedHealthcare

More information

CMS Limitations Guide - Radiology Services

CMS Limitations Guide - Radiology Services CMS Limitations Guide - Radiology Services Starting October 1, 2015, CMS will update their existing medical necessity limitations on tests and procedures to correspond to ICD-10 codes. This limitations

More information

6. The charge shown is only for patients without insurance.

6. The charge shown is only for patients without insurance. OTHER THERAPEUTIC PROCEDURES AND DIAGNOSTIC TESTING EMERGENCY ROOM, IV THERAPY, CARDIAC CATHETERIZATION, EKG, EEG, VACCINATION, ARTERIAL AND VASCULAR STUDIES For the Time Period : 10/01/16 and 09/30/2017

More information

Description MRI, TMJ C T Head Without Contrast C T Head With Contrast C T Head Without & With Contrast

Description MRI, TMJ C T Head Without Contrast C T Head With Contrast C T Head Without & With Contrast s Requiring Prior Authorization for the Advanced Imaging 70336 MRI, TMJ 70450 C T Head Without Contrast 70460 C T Head With Contrast 70470 C T Head Without & With Contrast 70480 C T Orbit Without Contrast

More information

DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY

DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DeltaCare USA Plan Type HMO Plan Name Silver Gold Exam & Diagnostics Office Exam Initial Oral Exam Periodic Oral Exam Teeth Cleaning Bite-Wing X-Ray Oral Surgery

More information

Physical and occupational therapy - rehabilitative

Physical and occupational therapy - rehabilitative Physical and occupational therapy - rehabilitative These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there

More information

DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY

DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DeltaCare USA Plan Type HMO Plan Name Silver Gold Exam & Diagnostics Office Exam Initial Oral Exam Periodic Oral Exam Teeth Cleaning Bite-Wing X-Ray Oral Surgery

More information

From Head to Toe Use of Advanced Dynamic Flow in prenatal ultrasound

From Head to Toe Use of Advanced Dynamic Flow in prenatal ultrasound From Head to Toe Use of Advanced Dynamic Flow in prenatal ultrasound Without doubt, the B- Schwerdtfeger, R. tant diagnostic instrument. Furthermore, we use colour in feto- mode imaging is the most important

More information

NOTE: Please append modifier 33 when indicated. If modifier 33 is not appended, regular plan benefits will be applied.

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

More information

Deep Vein Thrombosis and Pulmonary Embolism: Patient Information

Deep Vein Thrombosis and Pulmonary Embolism: Patient Information Deep Vein Thrombosis and Pulmonary Embolism: Patient Information A Deep Vein Thrombosis (DVT) and a Pulmonary Embolism (PE) are both disorders of unwanted blood clotting. Unwanted blood clots can occur

More information

HDlive Silhouette Mode With Spatiotemporal Image Correlation for Assessment of the Fetal Heart

HDlive Silhouette Mode With Spatiotemporal Image Correlation for Assessment of the Fetal Heart ORIGINAL RESEARCH HDlive Silhouette Mode With Spatiotemporal Image Correlation for Assessment of the Fetal Heart Toshiyuki Hata, MD, PhD, Mohamed Ahmed Mostafa AboEllail, MD, Suraphan Sajapala, MD, Mari

More information

Advanced Concepts of Personal Training Study Guide Answer Key

Advanced Concepts of Personal Training Study Guide Answer Key Advanced Concepts of Personal Training Study Guide Answer Key Lesson 22 Working with Special Populations LESSON TWENTY TWO Lesson Twenty Two Working with Special Populations WORKING WITH SPECIAL POPULATIONS

More information

Chiropractic. Table of Contents SCHEDULE OF FEES. Schedule EFFECTIVE MARCH 11, 2013

Chiropractic. Table of Contents SCHEDULE OF FEES. Schedule EFFECTIVE MARCH 11, 2013 Fee Schedule Chiropractic EFFECTIVE MARCH 11, 2013 Table of Contents SCHEDULE OF S Chiropractic Services... 2 Radiographic Examinations... 2 Reports... 4 Overview... 5 Billing the WSIB... 7 FORM 0722 (11/12)

More information

Pelvic Ultrasound.

Pelvic Ultrasound. Pelvic Ultrasound Before Your Exam: Drink 32 oz. of water one hour before your examination time. Try to drink all the liquid within 30 minutes. Do not urinate before the exam. Arrive for your exam with

More information

January Details of the fee code revisions can be found highlighted in Schedule A, attached.

January Details of the fee code revisions can be found highlighted in Schedule A, attached. Government of Newfoundland and Labrador Department of Health and Community Services January 2018 18-01 TO: RE: ALL FEE-FOR-SERVICE PHYSICIANS CHANGES TO DOPPLER ULTRASOUND FEE CODES The Department of Health

More information

Effective Date: 01/01/2014 Revision Date: Administered by:

Effective Date: 01/01/2014 Revision Date: Administered by: ARBenefits Approval: Effective Date: 01/01/2014 Revision Date: Administered by: Medical Policy Title: Physical and Occupational Therapy Services Document: ARB0476 Public Statement: 1) Physical and occupational

More information

ADI Procedure Codes. August 2016 Revised April 2017 Page 1 of 7 ADI Procedure Codes

ADI Procedure Codes. August 2016 Revised April 2017 Page 1 of 7 ADI Procedure Codes Code Description 70450 CT Head without contrast 70460 CT Head with contrast 70470 CT Head with & without contrast 70480 CT Orbit, et al without contrast 70481 CT Orbit, et al with contrast 70482 CT Orbit,

More information

RADIOLOGY PROGRAM TABLE OF CONTENTS. OVERVIEW. . Assessment... and... Certification

RADIOLOGY PROGRAM TABLE OF CONTENTS. OVERVIEW. . Assessment... and... Certification TABLE OF CONTENTS. OVERVIEW............................................................................................. 553..... Assessment............ and..... Certification..........................................................................

More information

Dr. Rami M. Adil Al-Hayali Assistant Professor in Medicine

Dr. Rami M. Adil Al-Hayali Assistant Professor in Medicine Dr. Rami M. Adil Al-Hayali Assistant Professor in Medicine Venous thromboembolism: pulmonary embolism (PE) deep vein thrombosis (DVT) 1% of all patients admitted to hospital 5% of in-hospital mortality

More information

SAY HELLO TO GOOD HEALTH.

SAY HELLO TO GOOD HEALTH. SAY HELLO TO GOOD HEALTH. WHY HEALTH CHECK-UP Good health is the foundation of a happy, productive and rewarding life. Most health problems can be managed more effectively if detected early. The modern

More information

Cigna - Prior Authorization Procedure List: Radiology & Cardiology

Cigna - Prior Authorization Procedure List: Radiology & Cardiology Cigna - Prior Authorization Procedure List: Radiology & Cardiology Category CPT Code CPT Code Description 93451 Right heart catheterization 93452 Left heart catheterization 93453 Combined right and left

More information

Swedish Technique Class

Swedish Technique Class Swedish Technique Class Massage of the Back Establish contact at the sacrum and occiput, and relax. Effleurage the whole back to apply oil, warm, and soften (3-6 times). Each effleurage of the whole back

More information

CPT 2015: Prepare Your Coding Practice For New Codes As Technology Makes An Advance

CPT 2015: Prepare Your Coding Practice For New Codes As Technology Makes An Advance 2015 Radiology Coding Survival Guide Section X : 2015 Coding Updates CPT 2015: Prepare Your Coding Practice For New Codes As Technology Makes An Advance Watch for changes in Vertebral fracture assessment,

More information

PREAMBLE GENERAL DIAGNOSTIC RADIOLOGY

PREAMBLE GENERAL DIAGNOSTIC RADIOLOGY PREAMBLE The General Diagnostic Radiology category is intended to cover the body of knowledge a practicing board certified Diagnostic Radiologist should know. Since the range of content relevant to the

More information

INTRODUCTORY TEXT BOX

INTRODUCTORY TEXT BOX INTRODUCTORY TEXT BOX Diagnostic Partners provides a range of onsite, in-office cardiac and vascular diagnostic testing services. From Resting Echocardiograms to Abdominal Aorta scans, each study is performed

More information

THE VESSELS OF BLOOD CIRCULATION

THE VESSELS OF BLOOD CIRCULATION THE VESSELS OF BLOOD CIRCULATION scientistcindy.com /the-vessels-of-blood-circulation.html NOTE: You should familiarize yourself with the anatomy of the heart and have a good understanding of the flow

More information

Prior Authorization for Non-emergency Cardiac Imaging Procedures

Prior Authorization for Non-emergency Cardiac Imaging Procedures Attention: All Providers Prior Authorization for Non-emergency Cardiac Imaging Procedures The N.C. Medicaid Program is considering implementation of a prior authorization (PA) program for non-emergency

More information

Radiography. 1. Introduction. 2. Documentation of Compliance. 3. Didactic Competency Requirements. 4. Clinical Competency Requirements

Radiography. 1. Introduction. 2. Documentation of Compliance. 3. Didactic Competency Requirements. 4. Clinical Competency Requirements PRIMARY CERTIFICATION AND REGISTRATION Radiography 1. Introduction Candidates for certification and registration are required to meet the Professional Education Requirements specified in the ARRT Rules

More information

Specific Basic Standards for Osteopathic Fellowship Training in Cardiology

Specific Basic Standards for Osteopathic Fellowship Training in Cardiology Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011

More information