The NCDs below are organized into separate tables by NCD Section. NCDs within each table are organized by NCD ID.
|
|
- Amie Armstrong
- 6 years ago
- Views:
Transcription
1 Three Penn Plaza East Newark, NJ HorizonBlue.com NCDs and LCDs to Be Implemented Claims submitted for services provided on and after April 9, 2018 to Horizon BCBSNJ MA members will be processed following the guidelines set forth in the NCDs, LCDs and/or their supporting articles listed below. The LCDs below are organized by LCD ID. LCD Title Assays for Vitamins and Metabolic Function Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control Allergy Testing Intensity Modulated Radiation Therapy (IMRT) BRCA1 and BRCA2 Genetic Testing Reflectance Confocal Microscopy Electroretinography (ERG) LCD ID L34914 L35011 L36241 L36711 L36715 L37375 L37371 The NCDs below are organized into separate tables by NCD Section. NCDs within each table are organized by. NCD Section 10: Anesthesia and Pain Management Autogenous Epidural Blood Graft 10.5 Anesthesia in Cardiac Pacemaker Surgery 10.6 NCD Section 20: Cardiovascular System Vertebral Artery Surgery 20.1 Cardiac Rehabilitation Programs for Chronic Heart Failure Intraoperative Ventricular Mapping Diagnostic Endocardial Electrical Stimulation Pacing HIS Bundle Study Cardiac Output Monitoring by Thoracic Electrical Bio-impedance (TEB) Ambulatory Blood Pressure Monitoring External Counterpulsation ECP Therapy for Severe Angina 20.2 Extracranial-Intracranial (EC-IC) Arterial Bypass Surgery 20.2 Chelation Therapy for Treatment of Atherosclerosis EthylenediamineTetraAcetic (EDTA) Chelation Therapy for Treatment of Atherosclerosis Fabric Wrapping of Abdominal Aneurysms Partial Ventriculectomy Cardiointegram CIG as an Alternative to Stress Test or Thallium Stress Test Hyperbaric Oxygen Therapy CMC An Independent Licensee of the Blue Cross and Blue Shield Association.
2 NCD Section 20: Cardiovascular System (continued) Microvolt TWave Alternans (MTWA) 20.3 Intensive Cardiac Rehabilitation (ICR) Programs Transcatheter Aortic Valve Replacement (TAVR) The Pritikin Program Ornish Program for Reversing Heart Disease Intensive Cardiac Rehabilitation Program Benson-Henry Institute Cardiac Wellness Program Transcatheter Mitral Valve Repair (TMVR) Percutaneous Left Atrial Appendage Closure (LAAC) Extracorporeal Immunoadsorption (ECI) Using Protein A Columns 20.5 Transmyocardial Revascularization (TMR) 20.6 Percutaneous Transluminal Angioplasty (PTA) 20.7 Artificial Hearts and Related Devices 20.9 NCD section 30: Complementary and Alternative Medicine Laetrile and Related Substances 30.7 Cellular Therapy 30.8 NCD section 40: Endocrine System and Metabolism Outpatient Intravenous Insulin Treatment 40.7 NCD section 70: Evaluation & Management of Patients - office/hospital/home Consultation Services Rendered by a Podiatrist in a Skilled Nursing Facility 70.2 NCD Section 80: Eye PhacoEmulsification Procedure Cataract Extraction 80.1 Vitrectomy Hydrophilic Contact Lenses 80.4 Intraocular Photography 80.6 Refractive Keratoplasty 80.7 NCD section 90: Genetics Pharmacogenomic Testing for Warfarin Response 90.1 NCD section 100: Gastrointestinal System Surgery for Diabetes Hour Ambulatory Esophageal ph Monitoring Gastric Freezing 100.6
3 NCD Section 110: Hematology/Immunology/Oncology Challenge Ingestion Food Testing Apheresis Therapeutic Pheresis Stem Cell Transplantation Formerly Extracorporeal Photopheresis NCD Section 130: Mental Health Hemodialysis for Treatment of Schizophrenia NCD section 140: Miscellaneous Surgical Procedures Abortion Plastic Surgery to Correct Moon Face NCD section 150: Musculoskeletal System Lumbar Artificial Disc Replacement LADR Manipulation Thermal Intradiscal Procedures (TIPs) Collagen Meniscus Implant Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee NCD section 160: Nervous System Induced Lesions of Nerve Tracts Invasive Intracranial Pressure Monitoring Electrotherapy for Treatment of Facial Nerve Paralysis Bell s Palsy Sensory Nerve Conduction Threshold Tests (sncts) Deep Brain Stimulation for Essential Tremor and Parkinson s Disease Stereotaxic Depth Electrode Implantation Electrical Nerve Stimulators NCD Section 190: Pathology and Laboratory Histocompatibility Testing Diagnostic Pap Smears Sweat Test Hair Analysis Lymphocyte Mitogen Response Assays NCD section 210: Pathology and Laboratory Prostate Cancer Screening Tests Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs Intensive Behavioral Therapy for Cardiovascular Disease Intensive Behavioral Therapy for Obesity
4 NCD section 210: Pathology and Laboratory (continued) Screening for Hepatitis C Virus (HCV) in Adults Lung Cancer Screening with Low Dose Computed Tomography (LDCT) Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer Screening for Cervical Cancer With Human Papillomavirus (HPV) Testing Counseling to Prevent Tobacco Use Screening for Hepatitis B Virus (HBV) Infection Screening for the Human Immunodeficiency Virus HIV Infection Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse Screening for Depression in Adults NCD section 220: Radiology Thermography Percutaneous Image Guided Breast Biopsy NCD section 230: Renal and Genitourinary System - ERSD Services Treatment of Kidney Stones Dimethyl Sulfoxide (DMSO) Ultrafiltration Monitor Sacral Nerve Stimulation For Urinary Incontinence Uroflowmetric Evaluations Sterilization Cryosurgery of Prostate NCD section 240: Respiratory System Lung Volume Reduction Surgery Reduction Pneumoplasty Heat Treatment including the use of Diathermy and Ultrasound for Pulmonary Conditions Sleep Testing for Obstructive Sleep Apnea (OSA) NCD section 250: Skin Treatment of Psoriasis Dermal Injections for the Treatment of Facial Lipodystrophy Syndrome (LDS) NCD section 260: Transplantation - Solid Organ Transplants Adult Liver Transplantation Heartsbreath Test for Heart Transplant Rejection Pediatric Liver Transplantation Pancreas Transplants Islet Cell Transplantation in the Context of a Clinical Trial Intestinal and MultiVisceral Transplantation Dental Examination Prior to Kidney Transplantation 260.6
5 NCD section 260: Transplantation - Solid Organ Transplants (continued) Lymphocyte Immune Globulin AntiThymocyte Globulin Equine Heart Transplants NCD section 270: Wound Treatment Electrical Stimulation ES and Electromagnetic Therapy for the Treatment of Wounds Blood Derived Products for Chronic Non-Healing Wounds NCD section 300: Diagnostic Tests Not Otherwise Classified Obsolete or Unreliable diagnostic tests 300.1
Medicare National Coverage Determinations Manual
Medicare National Coverage Determinations Manual Chapter 1, Part 1 (Sections 10 80.12) Coverage Determinations Transmittals for Chapter 1, Part 1 Table of Contents (Rev. 182, 05-22-15) Foreword - Purpose
More informationsad EFFECTIVE DATE: POLICY LAST UPDATED:
Medical Coverage Policy Prior Authorization via Web-Based Tool for Procedures sad EFFECTIVE DATE: 09 01 2015 POLICY LAST UPDATED: 12 18 2018 OVERVIEW This policy documents the prior authorization request
More informationsad EFFECTIVE DATE: POLICY LAST UPDATED:
Medical Coverage Policy Prior Authorization via Web-Based Tool for Procedures sad EFFECTIVE DATE: 09 01 2015 POLICY LAST UPDATED: 12 19 2017 OVERVIEW This policy documents the prior authorization request
More informationsad EFFECTIVE DATE: POLICY LAST UPDATED:
Medical Coverage Policy Prior Authorization via Web-Based Tool for Procedures sad EFFECTIVE DATE: 09 01 2015 POLICY LAST UPDATED: 12 19 2017 FOR INTERNAL USE ONLY: An RSS was requested to remove prior
More information* PLACE OF SERVICE REQUIREMENTS FOR ADDITIONAL HIGHMARK WV MEDICAL POLICIES ANNOUNCED IN THE FEBRUARY 2011 ISSUE OF PROVIDER NEWS *
* PLACE OF SERVICE REQUIREMENTS FOR ADDITIONAL HIGHMARK WV MEDICAL POLICIES ANNOUNCED IN THE FEBRUARY ISSUE OF PROVIDER NEWS * Read this bulletin on-line via NaviNet MARCH 25, HWVPROV--004 TO: FROM: (1)
More informationCY2015 Hospital Outpatient: Endovascular Procedure APCs and Complexity Adjustments
CY2015 Hospital Outpatient: Endovascular Procedure APCs Complexity Adjustments Comprehensive Ambulatory Payment Classifications (c-apcs) CMS finalized the implementation of 25 Comprehensive APC to further
More informationต วอย าง AF เคร องม อทางการแพทย ท จะศ กษาท ม ความเส ยงน อยและความเส ยงมาก
EXAMPLES: ต วอย าง เคร องม อทางการแพทย ท จะศ กษาท ม ความเส ยงน อยและความเส ยงมาก ต วอย างเคร องม อทางการแพทย ท จะศ กษาท ม ความเส ยงน อย NON-SIGNIFICANT RISK DEVICE STUDIES Bio-stimulation Lasers for treatment
More informationHorizonBlue.com. We ve got you covered. Preventive care at no cost to you.
HorizonBlue.com We ve got you covered. Preventive care at no cost to you. Did you know that Horizon Blue Cross Blue Shield of New Jersey provides full coverage for certain preventive services at no cost
More informationMedicare National Coverage Determinations Manual
Medicare National Coverage Determinations Manual Chapter 1, Part 1 (Sections 10 80.12) Coverage Determinations Transmittals for Chapter 1, Part 1 Table of Contents (Rev. 175, 10-03-14) Foreword - Purpose
More informationA PROVIDER S GUIDE TO PREVENTIVE HEALTH SERVICES FOR YOUR PATIENTS
ConnectiCare, together with the Centers for Medicare & Medicaid Services, encourages the use of preventive health services. For certain basic preventive health services, ConnectiCare Medicare Plan beneficiaries
More information2016 MDwise Excel Network Hoosier Healthwise Medical Services that Require Prior Authorization
2016 MDwise Excel Network Hoosier Healthwise Medical Services that Require Prior Authorization Medical services that require Prior Authorization Type of Service Requires PA Coding All Out of Network services
More informationArteriovenostomy for renal dialysis 39.27, 39.42
Surgery categories NHSN Surgery codes (Reference: NHSN Operative Procedure Category Mappings to ICD-9-CM Codes, October 2010 www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf) Operative aortic aneurysm
More informationA PROVIDER S GUIDE TO PREVENTIVE HEALTH SERVICES FOR YOUR PATIENTS
ConnectiCare, together with the Centers for Medicare & Medicaid Services, encourages the use of preventive health services. For certain basic preventive health services, ConnectiCare Medicare Plan beneficiaries
More informationPREVENTIVE CARE RECOMMENDATIONS Detailed descriptions
PREVENTIVE CARE RECOMMENDATIONS Detailed descriptions How often and what kind of preventive care services you need depends upon your age, gender, health and family history. Not all items on this list are
More information2018 Preventive Schedule
2018 Preventive Schedule Medicare-Covered Services PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat.
More informationArizona Clover Health Choice PPO (040) 2019 Medical Benefits
Arizona 2019 Medical Benefits Effective Date: 1/1/2019 Version 1.0 Part D Deductible For Part D Copay information, see page 26. /year for Part D prescription drugs /year for Part D prescription drugs Out-of-Pocket
More informationGeorgia Green (Plan 026) 2018 Medical Benefits
Georgia Green (Plan 026) 2018 Medical Benefits Effective Date: 1/1/2018 Version 1.0 Part D Deductible For Part D Copay information, see page 26. Out-of-Pocket Max $100/year for Part D prescription drugs
More informationPennslyvania Green (Plan 028) 2018 Medical Benefits
Pennslyvania Green (Plan 028) 2018 Medical Benefits Effective Date: 1/1/2018 Version 1.0 Part D Deductible For Part D Copay information, see page 25. $150/year for Part D prescription drugs Tiers 1 and
More informationMEDICAL HISTORY. Previous Nephrologist. Medication taken Insulin Oral Both. Who manages your diabetes? Blindness Yes No Hearing Problems Yes No
MEDICAL HISTORY Please mark YES or NO and fill in appropriate blanks as needed Chronic Yes No If yes, year diagnosed Previous Nephrologist Transplant Yes No If yes, date Donor type Living Deceased Related
More informationPLACE OF SERVICE REQUIREMENTS INCLUDED ON CERTAIN HIGHMARK WV MEDICAL POLICIES *
* PLACE OF SERVICE REQUIREMENTS INCLUDED ON CERTAIN HIGHMARK WV MEDICAL POLICIES * Read this bulletin on-line via NaviNet JANUARY 20, 2011 HWV-PROV-2011-003 TO: (1) CHIEF FINANCIAL OFFICER (2) DIRECTOR/MANAGER
More informationChapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 33010-33130, 33140, 33141, 33361-33369, 33200-37186, 37195-37785, 92950-93272,
More informationCY2017 Hospital Outpatient: Vascular Procedure APCs and Complexity Adjustments
CY2017 Hospital Outpatient: Vascular Procedure APCs and Complexity Adjustments Comprehensive Ambulatory Payment Classifications (c-apcs) In CY2015 and in an effort to help pay providers for quality, not
More informationIN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services)
HMO-OA-CAL-15-15-0-0-03 HMO Open Access Calendar Year Plan Benefit Summary This is a brief summary of benefits. Refer to your Membership Agreement for complete details on benefits, conditions, limitations
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: September 2, 2014 The following Medical Protocol update includes information on protocols that have undergone a review over the last several
More informationOregon 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
More informationTusculum College. Benefit Summary. $25 Copay. $25 Copay. after Deductible. 20% after Deductible 20% after Deductible
Benefit Plan Features: Annual Deductible Benefit Summary Your Cost In-Network Individual/Family $750/$1500 Annual Out-of-Pocket Maximum Individual/Family $3500/$7000 4th Quarter Carry-over Covered Services
More informationBlue represents coding updates. G0389 with diagnosis V81.2, V15.82, or with diagnosis V79.1, or
An Independent Licensee of the Blue Cross and Blue Shield Association Preventive Care Services The following is a list of preventive services (HCP rider) along with the diagnoses and procedure codes that
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: June 2, 2014 The following Medical Protocol update includes information on protocols that have undergone a review over the last several months
More informationIN-NETWORK MEMBER PAYS. Contract Year Plan Deductible (Deductible is combined for health services and prescription drugs) $5,000 Individual
HMO-OA-CNT-HSA-5000I/10000F-07 Contract Year Benefit Summary (E) Point-Of-Service Open Access High Deductible Health Plan (HDHP) for use with a Health Savings Account (HSA) This is a brief summary of benefits.
More informationApril 6, 2017 VIA ELECTRONIC MAIL
April 6, 2017 VIA ELECTRONIC MAIL Patricia Brooks, RHIA Centers for Medicare and Medicaid Services CMM, HAPG, Division of Acute Care Mail Stop C4-08-06 7500 Security Boulevard Baltimore, Maryland 21244-1850
More informationNEW YORK STATE TEAMSTERS COUNCIL HEALTH & HOSPITAL FUND APPENDIX A SCHEDULE OF BENEFITS SUPREME BENEFITS
BENEFIT GUIDE NEW YORK STATE TEAMSTERS COUNCIL HEALTH & HOSPITAL FUND APPENDIX A SCHEDULE OF SUPREME IN NETWORK FEATURES Primary Care Physician Not Required 2 Physician Referrals Not Required 2 Out of
More informationREVENUE CODE LIST REQUIRING CPT/HCPCS CODES FOR OUTPATIENT FACILITY CLAIMS
REVENUE CODE LIST REQUIRING CPT/HCPCS CODES FOR OUTPATIENT FACILITY CLAIMS For Providers Effective July 15, 2018 Revenue Code Description 240 All inclusive ancillary, general 250 Pharmacy 251 Drugs, generic
More informationPrior Authorization List Effective February 2, 2015
Prior Authorization List Effective February 2, 2015 Prior authorization is required for the following services. Prior authorization is the responsibility of the provider ordering or rendering services
More informationPOLICY 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.
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: June 1, 2017 The following update includes information on protocols that have undergone a review over the last several months, or an additional
More informationChapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 33010-33130, 33140, 33141, 33200-37186, 37195-37785, 92950-93272, 93303-93581,
More informationHealthcare Reform Preventive Services
An Independent Licensee of the Blue Cross and Blue Shield Association The following preventive services and immunizations do not apply to all health plans administered or insured by Blue Cross and Blue
More informationInformed Consent for Liver Transplant Patients
Informed Consent for Liver Transplant Patients Evaluation Process You will be evaluated with consultations, lab tests and various procedures to determine the medical appropriateness of liver transplant.
More informationPreventive Care Services Summary
Preventive Care Services Summary Below is a list of preventive services along with the diagnoses and procedure codes that Community Health Options has determined to meet or exceed the requirements and
More informationPreventive Care Services Summary
Preventive Care Services Summary Below is a list of preventive services along with the diagnoses and procedure codes that Community Health Options has determined to meet or exceed the requirements and
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationTusculum College. Benefit Summary Option/Quote: 2. 30% after Deductible. $35 Copay. 30% after Deductible
Benefit Plan Features: Annual Deductible Effective Date: 4/1/2018 Network: S Benefit Summary Option/Quote: 2 Your Cost In-Network Individual/Family $1250/$2500 Annual Out-of-Pocket Maximum Tusculum College
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: September 1, 2016 The following Medical Protocol update includes information on protocols that have undergone a review over the last several
More informationDiagnostic & Therapeutic Cardiac Catheterization Coder 2017
Diagnostic & Therapeutic Cardiac Catheterization Coder 2017 Including peripheral and cardiovascular services and procedures Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare
More information2017 Eligible Measure Applicability (EMA) for Registry Data Submission of Individual Quality Measures
2017 Eligible Measure Applicability (EMA) for Registry Data Submission of Individual Quality Measures 07/17/2017 Page 1 of 10 QPP Clinically Related Measure Analysis Used in EMA Clinical Relation including
More informationPLEASE LET US KNOW YOUR REASON FOR TODAY S VISIT : CURRENT MEDICATIONS (WITH DOSAGE) PLEASE INCLUDE VITAMINS AND HERBAL MEDICATIONS:
1 NAME: DATE OF BIRTH PLEASE LET US KNOW YOUR REASON FOR TODAY S VISIT : CURRENT MEDICATIONS (WITH DOSAGE) PLEASE INCLUDE VITAMINS AND HERBAL MEDICATIONS: PAST MEDICAL HISTORY (YOUR MEDICAL HISTORY) :
More informationChapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 33010-33130, 33140, 33141, 33361-33369, 33200-37186, 37195-37785, 92950-93272,
More informationHigh-Acuity Nursing. Global edition. Global edition. Kathleen Dorman Wagner Melanie G. Hardin-Pierce
High-Acuity Nursing For these Global Editions, the editorial team at Pearson has collaborated with educators across the world to address a wide range of subjects and requirements, equipping students with
More informationForm C KNHSS Operative Procedure Categories Codes
Form C KNHSS Operative Procedure Categories Codes NHSN Operative Procedure Category Mappings to ICD-9-CM Codes and CPT Codes CPT codes are to be used for outpatient surgery cases only. KNHSS Code NHSN
More informationWomen s Preventive Health Guidelines
Women s Preventive Health Guidelines I. University Health Alliance (UHA) will reimburse for women s preventive health services when it meets the clinical preventive services guidelines below. II. Description
More informationJan 30, Dear Provider:
Jan 30, 2015 Dear Provider: Kern Health Systems strives to provide quality and timely services to our members. Recently, KHS made changes to the services included on Prior Authorization Needed list. The
More informationChapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationUpdates for CPT for 2011 Part I
Updates for CPT for 2011 Part I Presented by Alice Marie Reybitz, RN, BA, CPC, CPC-H, CPC-I H 1 Objectives What codes were added, revised, or deleted Why were these codes added, revised, or deleted How
More informationExperimental and investigational procedure codes
Experimental and investigational procedure codes Following are updated experimental and investigational procedure codes and associated supporting policies effective January 1, 2018. Procedure codes 0001M
More informationMyCare 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
More informationChapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 61000-61626, 61680-62264, 62268-62284, 62290-63048, 63055-64484, 64505-64595,
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: June 1, 2010 The following clinical protocol update includes information on protocols that have had an annual review recently resulting in
More informationPeripheral and Cardiology Coder 2018
Peripheral and Cardiology Coder 2018 Cardiovascular Services and Procedures Prepared and Published By: MedLearn Publishing A Division of MedLearn Media, Inc. 445 Minnesota Street, Suite 514 St. Paul, MN
More informationOutpatient Specialty Referral Request Types
What is a request type? Request types are templates created for use with Health Net Federal Services, LLC s (HNFS) online referral and authorization submission tools, available at www.tricare-west.com
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Nephrology
Specific Basic Standards for Osteopathic Fellowship Training in Nephrology American Osteopathic Association and American College of Osteopathic Internists BOT Rev. 2/2011 These specific basic standards
More informationSample page. POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years. Visit optum360coding.com.
2018 Complete Guide for Interventional Radiology An in-depth guide to interventional radiology coding, billing, and reimbursement for facilities and physicians POWER UP YOUR CODING with Optum360, your
More informationFrom A to Z-Codes Matter
From A to Z-Codes Matter Susan Wallace, MEd, RHIA, CCS, CDIP, CCDS, FAHIMA While ALL ICD-10-CM codes are important, the Z-codes in ICD-10-CM are frequently considered step-children, supplemental codes
More informationCardiac Rhythm Management Coder 2018
Cardiac Rhythm Management Coder 2018 An easy-to-use tool for coding and reimbursement compliance Prepared and Published By: MedLearn Publishing, A Division of MedLearn Media, Inc. 445 Minnesota Street,
More informationPreventive Services Reference Guide for Members 2018
Preventive Services Reference Guide for Members 2018 Together with Children s Community Health Plan (CCHP) covers many preventive services at no cost to you, including screening tests and immunizations
More informationSUPPLEMENTAL DIGITAL CONTENT 2 : SURGERY SUBGROUPS DEFINITONS AND DISTRIBUTION
mortality 24h in ICU mortality 24h in ICU 1 SUPPLEMETAL DIGITAL COTET 2 : SURGERY SUBGROUPS DEFIITOS AD DISTRIBUTIO =2,717,902 GHM codes* Surgery description CARDIAC SURGERY 05C021 to 05C034 Cardiac valve(s)
More informationBasics of Interventional Radiology Coding 2017
Basics of Interventional Radiology Coding 2017 Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare Solutions, Inc. 287 East Sixth Street, Suite 400 St. Paul, MN 55101 1-800-252-1578
More informationMDwise Community Health Network Hoosier Healthwise Medical Services that Require Prior Authorization
MDwise Community Health Network Hoosier Healthwise Medical Services that Require Prior Authorization Medical services that require Prior Authorization Type of Service Requires PA Coding All Out of Network
More informationEffective April 7, 2014 UTILIZATION MANAGEMENT STANDARD CLINICAL REVIEW PREAUTHORIZATION LIST IMPORTANT
Effective April 7, 2014 UTILIZATION MANAGEMENT STANDARD CLINICAL REVIEW PREAUTHORIZATION LIST The following services require clinical review preauthorization for commercial managed care products, Medicare,
More informationNov FromAtoZCodesMatter
Nov 2017 FromAtoZCodesMatter From A to Z-Codes Matter Susan Wallace, MEd, RHIA, CCS, CDIP, CCDS, FAHIMA The implementation of ICD-10 brought tens of thousands of new codes. Ranging from A to Z, they portray
More informationChapter 13 Worksheet Code It
Class: Date: Chapter 13 Worksheet 3 2 1 Code It True/False Indicate whether the statement is true or false. 1. A cardiac catheterization diverts blood from the heart to the aorta. 2. Selective vascular
More informationCoverage for preventive care
Coverage for preventive care Understanding your preventive care coverage Preventive care, like screenings and immunizations, helps you and your family stay healthier and can help lower your overall out-of-pocket
More informationVASCULAR SURGERY PATIENT HEALTH HISTORY
VASCULAR SURGERY PATIENT HEALTH HISTORY Chief Complaint - Please describe the problem that brings you into the office today: Allergies 1. Do you have any allergies? if so, please list To Medications? To
More informationDETAILED 2014 PREVENTIVE CARE SERVICES
DETAILED 2014 PREVENTIVE CARE SERVICES How often and what kind of preventive care services you need depends upon your age, gender, health and family history. Your provider determines whether services delivered
More informationPLAS/RECON SURGERY PATIENT HEALTH HISTORY
PLAS/RECON SURGERY PATIENT HEALTH HISTORY Chief Complaint - Please describe the problem that brings you into the office today: Allergies 1. Do you have any allergies? if so, please list To Medications?
More informationEmpire BlueCross BlueShield Professional Reimbursement Policy
Subject: Frequency Editing NY Policy: 0016 Effective: 05/01/2015 08/16/2015 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria
More informationbilateral, 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 informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Table S1. Patient Selection Codes, CIED Generator Procedures Code Type Code Description ICD9 Proc 00.51 Implantation of cardiac resynchronization defibrillator, total system [CRT-D]
More informationPatient Name Date of Birth MALE / FEMALE Date. Left handed or Right handed. Marital Status: Single Married Divorced Widowed Children?
PH NEW PATIENT HISTORY Patient Name Date of Birth MALE / FEMALE Date Occupation: Left handed or Right handed Marital Status: Single Married Divorced Widowed Children? Y or N # Previous Treating Physician:
More informationCell Phone #: Home Phone #: ** Address (prefer your forever address):
NEW PATIENT QUESTIONNAIRE * Some of this information is required by the CMS (Centers for Medicare and Medicaid Services). Your demographic answers will never affect your care. Today s Date: **Date of Birth:
More informationBILLING BULLETIN. Re: Interventional Cardiology. Bulletin #: 1. Date Issued: November 10, Background
BILLING BULLETIN Re: Interventional Cardiology Bulletin #: 1 Date Issued: November 10, 2016 Background This Billing Bulletin provides billing guidance when submitting claims to Manitoba Health, Seniors
More informationNorthwest Georgia Surgical Specialists, PC PAST MEDICAL HISTORY
orthwest Georgia Surgical Specialists, PC Medical History Form ame Date of visit Last First MI Day ear Date of Birth Age Gender Marital Status Height Weight Day ear Referring Doctor Reason for Visit PAST
More informationS2 File. Clinical Classifications Software (CCS). The CCS is a
S2 File. Clinical Classifications Software (CCS). The CCS is a diagnosis categorization scheme based on the ICD-9-CM that aggregates all diagnosis codes into 262 mutually exclusive, clinically homogeneous
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: March 1, 2011 The following clinical protocol update includes information on protocols that have had an annual review recently resulting in
More informationENROLLMENT : Line of Business Summary
ENROLLMENT : Line of Business Summary Date Range : JAN 2017 through DEC 2017 COMPREHENSIVE MAJOR MEDICAL Print Date : 1/19/2018 9:43:49AM Page 1 of 1 Month Year Single 2 Person : Emp/Spouse 2 Person :
More informationMedicare Claims Processing Manual
Medicare Claims Processing Manual Chapter 32 Billing Requirements for Special Services Table of Contents (Rev. 3811, 07-25-17) (Rev. 3815, 07-28-17) Transmittals for Chapter 32 10- Diagnostic Blood Pressure
More informationUPMC University of Pittsburgh Medical Center. For Reference Only MEDICINE 2013
Summary of Services and Availability (by location) Each location has sufficient space, equipment, staffing and financial resources in place or available in sufficient time as required to support each requested
More informationPreventive Care Coverage
STAYING WELL Preventive Care Coverage Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association Wondering what preventive care your plan covers? Our
More information2011 CPT Code Update. Diagnostic Radiology. Computed Tomography (CT), Abdomen and Pelvis. Deletion of Xeroradiography and Subtraction Codes
2011 CPT Code Update [The Health Insurance Portability and Accountability Act [HIPAA] transaction and code set rules require the use of the medical code set that is valid at the time a service is provided.
More informationEpisodes of Care Risk Adjustment
Episodes of Care Risk Adjustment Episode Types Wave 1 Asthma Acute Exacerbation Perinatal Total Joint Replacement Wave 2 Acute Percutaneous Coronary Intervention COPD Acute Exacerbation Non-acute Percutaneous
More informationSelected tables standardised to Segi population
Selected tables standardised to Segi population LIST OF TABLES Table 4.2S: Selected causes of death, all-ages, 2000 2004 (Segi Standard) Table 5.3S: Public hospitalisations by major cause of admission
More information2012 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
More informationPatient Health History
Patient Health History This information is very important in your care. Please complete as carefully and accurately as possible. Name: Date: Height: inches Weight: lbs Age: Symptoms: 1. Type of symptoms
More informationMedical Services Protocol Updates
Protocol Medical Services Protocol Updates Distribution Date: June 1, 2018 The following medical protocol update includes information on protocols that have undergone an annual review over the last several
More informationStatement of Coverage. Preventive Health Services Policy. Policy Specific Section: Preventive Health Guidelines
Statement of Coverage Preventive Health Services Policy Type: Preventive Health Guidelines Policy Specific Section: Medicine Group Plans Effective Date: September 23, 2010 * or upon renewal * Effective
More informationNOACS/DOACS*: PERI-OPERATIVE MANAGEMENT
NOACS/DOACS*: PERI-OPERATIVE MANAGEMENT OBJECTIVE: To provide guidance for the peri-operative management of patients who are receiving a newer direct oral anticoagulant (DOAC) and require an elective surgery/procedure.
More information1. CARDIOLOGY. These listings cannot be correctly interpreted without reference to the Preamble. Anes. $ Level
1. CARDIOLOGY These listings cannot be correctly interpreted without reference to the Preamble. Anes. Referred Cases 33010 Consultation: To consist of examination, review of history, laboratory, X-ray
More informationIs your Find a Doctor everything it can be?
Is your Find a Doctor everything it can be? Ranked #1 in most pediatric specialties in Illinoisi Voted one of the best places to work FIND A DOCTOR Research Usability studies & interviews Performance
More informationHighland Colony Dental- Donald K. Givan, DMD
Highland Colony Dental- Donald K. Givan, DMD ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRAcTICES *You May Refuse to Sign This Acknowledgement* I, have received a copy of this office s Notice of Privacy
More information