CARECORE NATIONAL OUTPATIENT IMAGING SELF-REFERRAL PAYMENT POLICIES PUBLISHED APRIL 2013
|
|
- Henry Harrell
- 5 years ago
- Views:
Transcription
1 CARECORE NATIONAL OUTPATIENT IMAGING SELF-REFERRAL PAYMENT POLICIES PUBLISHED APRIL 2013 The outpatient imaging self-referral payment policies are designed to promote appropriate use of diagnostic imaging by primary care physicians, specialty physicians and other health care professionals in office settings. The CareCore National payment policies below designate which imaging procedures shall be payable by the health plan (subject to member benefits) in primary care physicians, specialty physicians and other health care professionals offices by provider practice specialty. In addition, these payment policies describe the minimum accreditation and certification requirements for ultrasound, echocardiography and nuclear medicine. This payment policy assumes board certification (by an ABMS recognized board) in the provider specialties listed below. All specialty payment policies apply to the related pediatric specialties as well. Primary Care Physicians: to Chest imaging Internal Medicine, Family Practice Cardiologists (includes cardiovascular specialist, interventional cardiologist, and cardiac electrophysiologist) to Chest imaging pericardiocentesis endomyocardial biopsy Cardiologists, Nuclear 78451*, 78452*, 78453*, 78454* 78466*, 78468*, 78469* 78472*, 78473*, 78481*, 78483*, 78494* Myocardial perfusion imaging Myocardial infarction scans Cardiac blood pool imaging 1.) Certification by the American Board of Radiology (ABR), the American Board of Nuclear Medicine (ABNM) or the Certification Board for Nuclear Cardiology (CBNC) 2.) Laboratories accredited by the Intersocietal Commission for the Accreditation of Nuclear Laboratories (IAC Nuclear/PET)*** or the American College of Radiology (ACR) NY021680_PRO_LTR_ENG Internal Approved WellCare 2013 NY_03_
2 Pediatric Cardiologists 76825** to 76828** Echocardiography, fetal 71555* MRA Chest 75557* to 75563* Cardiac MRI to Chest imaging pericardiocentesis endomyocardial biopsy Chiropractors 72010, 72040, 72069, 72070, 72080, Colon & Rectal Surgeons Spine imaging Ultrasound, transrectal biopsy Endocrinologists Thyroid ultrasound biopsy 1.)Certification in pediatric cardiology by the American Board of Pediatrics 2.)Laboratories accredited by the Intersocietal Accreditation Commission for Echocardiography Laboratories (ICAEL) Certification by the American Board of Colon & Rectal Surgery (ABCRS) AACE/ECNU (Endocrine Certification for Neck Ultrasound) Accreditation Gastroenterologists Endoscopic ultrasound General Surgeons biopsy Breast ultrasound For breast ultrasound and ultrasound-guided breast biopsy: Hand Surgeons to Upper extremity imaging Physicians must be certified in breast ultrasound by the American Society of Breast Surgeons (ASBS) -and- Facilities must have accreditation from the ASBS for breast ultrasound and ultrasound-guided breast biopsy or be accredited by the American College of Radiology in breast ultrasound and ultrasound-guided breast biopsy Head and Neck Surgeons (ENT, otolaryngologist) Hematologist/Oncologists Medical Oncologists Oncologists biopsy to Chest imaging
3 Maternal and Fetal Medicine Hysterosalpingography Computer aided detection, 77057, G **, 76816**, 76817**, 76820**, 76821** to **, 76802**, 76805**, 76810**, 76811**, 76812**, 76813**, 76814**, 76818**, 76819**, 76820**, 76821**, 76825**, 76826**, 76827**, 76828** Nephrologists * Screening Mammography Ultrasound: obstetrical, pelvic, guidance Ultrasonic guidance aspiration of ova Ultrasound: obstetrical, pelvic, guidance Ultrasound study, follow-up fetal transfusion or cordocentesis chorionic villus sampling amniocentesis Angiography arteriovenous shunt, radiological supervision and interpretation Venous angioplasty, radiological supervision and interpretation MR guidance for needle placement CT scan for needle biopsy Fluoroscopic guidance biopsy Must be fully compliant with MQSA requirements to perform AIUM/ACR Accreditation Nuclear Medicine All nuclear medicine studies are included in this section, please consult your Provider Manual to determine which nuclear studies require pre-certification. Or call CareCore National for assistance at Physicians must be certified by the American Board of Radiology (ABR) or the American Board of Nuclear Medicine (ABNM).
4 OB/GYN Computer aided detection, 77057, G0202 Screening Mammography Hysterosalpingography 76815**, 76816**, 76817** to Ultrasound: obstetrical, pelvic Ultrasonic guidance aspiration of ova **, 76802**, 76805**, 76810**, 76811**, 76812**, 76813**, 76814**, 76818**, 76819**, 76820**, 76821**, 76825**, 76826**, 76827**, 76828** Ultrasound study, follow-up Ultrasound: obstetrical, pelvic Must be fully compliant with MQSA requirements to perform AIUM/ACR accreditation fetal transfusion or cordocentesis chorionic villus sampling amniocentesis Oral Surgeons 70100, 70110, 70140, , 70310, , Orthopedists (including Pediatric Orthopedists) to to to 72120,72170, 72190, to to 73140, to , 77003* Mandible and facial bone imaging Teeth imaging TMJ imaging Cephalogram, orthodontic orthopantogram Radiologic examination, ribs Radiologic examination, sternum Spine and pelvis imaging Imaging to upper and lower extremities Fluoroscopic guidance biopsy Radiologic examination, any joint Bone length studies Joint survey Ultrasound, extremity Ultrasound, extremity, limited Ultrasound, infant hips Ultrasound, infant hips, limited Pain Specialists (physiatrists, 72275* Epidurography anesthesiologists, neurologists, and neurosurgeons) 77002, 77003* Fluoroscopic guidance Pediatricians to Chest imaging AIUM accreditation in musculoskeletal ultrasound
5 Podiatrists 73620, 73630, 73650, Lower extremity imaging Pulmonologists to Chest Imaging Radiation Oncologists CT guidance for needle placement CT guidance for placement of radiation therapy fields Prostate volume study for brachytherapy treatment planning placement of radiation therapy fields interstitial radioelement application Reproductive Endocrinologists Computer aided detection, 77057, G0202 Screening Mammography Ultrasound, obstetrical, pelvic 76815**, 76816**, 76817** to Rheumatologists to 72120,72170, to to 73140, to , Ultrasound study, follow-up Hysterosalpingography Spine and pelvis imaging Imaging - Upper and lower extremities Must be fully compliant with MQSA requirements to perform 77073, Sports Medicine to , to , to to to biopsy Bone length studies, joint survey Ultrasound, extremity Ultrasound, extremity, limited Ultrasound, infant hips Ultrasound, infant hips, limited Radiologic examination, ribs Radiologic examination, sternum Spine and pelvis imaging Imaging to upper and lower extremities AIUM accreditation in musculoskeletal ultrasound Board certification in sports medicine and combined fellowship, residency and training in sports medicine of at least four years
6 Urologists Ultrasound, retroperitoneal, limited 76870, Ultrasound, scrotum, transrectal Prostate volume study for brachytherapy treatment planning Ultrasound guidance for biopsy Ultrasound guidance for interstitial radioelement placement Ultrasound, pelvic, limited or follow up Vascular Neurology Vascular Surgeons Aortography, thoracic, without serialography Angiography, external carotid, unilateral, selective Angiography, external carotid, bilateral, selective Angiography, carotid, cerebral, unilateral Angiography, carotid, cerebral, bilateral Angiography, carotid, cervical, unilateral Angiography, carotid, cervical, bilateral Angiography, vertebral, cervical and/or intracranial Transcatheter therapy, embolization Transcatheter therapy, infusion Angiography through existing catheter Cineradiography/ Videoradiography Fluoroscopic guidance for central venous access device Ultrasound guidance for vascular access Certification by the American Board of Medical Specialties (ABMS) in Vascular Neurology
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 informationLoma Linda University Medical Center Loma Linda, CA RADIOLOGY SERVICE PRIVILEGE FORM
Name: Page 1 of 10 REQUEST CATEGORY MEMBERSHIP CATEGORY Provisional Administrative Affiliate Active Courtesy Consulting All initial appointees shall be placed in the Provisional Category for the duration
More informationRadiology CPT. CPT copyright 2011 American Medical Association. All rights reserved.
Radiology CPT CPT copyright 2011 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not
More information2013 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 informationChapter 16 Worksheet Code It
Name: Class: Date: ID: A Chapter 16 Worksheet 3 2 1 Code It True/False Indicate whether the statement is true or false. 1. CT scans generate three-dimensional images. 2. An ultrasound produces images of
More informationSPECIALTY CPT CODES DESCRIPTION
Primary Care Physicians: Internal Medicine, Family Practice, Pediatrics 71010, 71020, 71021, 71022, 71030, 71100, 71101, 71110, 72010, 72020, 72040, 72050, 72052, 72070, 72080, 72100, 72110, 72114, 72170,
More informationADI 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 information2. Please complete a separate application for each physical location. 3. Professional or Read-Only Groups interpreting imaging
Highmark Professional Provider Privileging Application INSTRUCTIONS 1. Complete this application if you provide any diagnostic imaging services. 2. Please complete a separate application for each physical
More informationEUROSON SCHOOL 2019 January 18-19, 2019, Athens-Greece Preliminary Programme
EUROSON SCHOOL 2019 January 18-19, 2019, Athens-Greece Preliminary Programme 08:00-09:00 Registration Friday, January 18 Theoretical Course / PHYSICS AND TECHNOLOGY 09:00-09:15 Basics in US Physics 09:15-09:30
More informationHighmark Privileging Application. 1. Complete this application if you provide any diagnostic
Highmark Privileging Application INSTRUCTIONS 1. Complete this application if you provide any diagnostic imaging services. 2. Please complete a separate application for each physical location where imaging
More informationCigna - 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 informationCOMPETENCY REQUIREMENTS for the CERTIFICATION EXAMINATION
COMPETENCY REQUIREMENTS for the 10/2013 CERTIFICATION BOARD FOR RADIOLOGY PRACTITIONER ASSISTANTS CERTIFICATION EXAMINATION Note: The competency requirements contained in this document will be in effect
More informationCPT 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 informationRADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGING For the Time Period : 10/01/16 and 09/30/2017
RADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGING For the Time Period : 10/01/16 and 09/30/2017 IF YOU ARE COVERED BY HEALTH INSURANCE, YOU ARE STRONGLY ENCOURAGED TO CONSULT
More informationRADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGIN For the Time Period : 10/01/16 and 09/30/2017
RADIOLOGY - X-RAY - COMPUTERIZED AXIAL TOMMOGRAPHY - MAGNETIC RESONENCE IMAGIN For the Time Period : 10/01/16 and 09/30/2017 IF YOU ARE COVERED BY HEALTH INSURANCE, YOU ARE STRONGLY ENCOURAGED TO CONSULT
More information73725x2 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 informationHigh Tech Imaging Quick Reference Guide
High Tech Imaging Quick Reference Guide 1 High Tech Imaging Authorizations may now be requested through our secure provider portal, BlueAccess. Getting Started Step 1: Log into BlueAccess from www.bcbst.com
More informationDiagnostic Imaging Providers Privileging Guidelines
Diagnostic Imaging Providers Privileging Guidelines The following guidelines are intended to promote reasonable and consistent quality and safety standards for the provision of imaging services. These
More informationHIP 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 informationRadiology Codes Requiring Authorization*
70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) 70450 Computed tomography, head or brain; without contrast material 70460 Computed tomography, head or brain; with contrast material(s)
More informationCigna - 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 informationHEALTHFIRST 2011 RADIOLOGY PROGRAM CODE LIST
HEALTHFIRST 2011 RADIOLOGY PROGRAM CODE LIST Outpatient Radiology utilization call Carecore at 1-877-773-6964 Modality CPT CODE Description CT SCANS 70450 CT HEAD/BRAIN W/O CONTRAST CT SCANS 70460 CT HEAD/BRAIN
More informationNow iknow SM : Frequently Asked Questions
Now iknow SM : Frequently Asked Questions Overview Beginning December 2013, Harvard Pilgrim in partnership with Castlight Health, a leader in health care transparency will introduce a new online health
More informationUNMH Radiology Clinical Privileges. Name: Effective Dates: From To
All new applicants must meet the following requirements as approved by the UNMH Board of Trustees, effective April 28, 2017: Initial Privileges (initial appointment) Renewal of Privileges (reappointment)
More informationMAGNETIC RESONANCE IMAGING (MRI) AND COMPUTED TOMOGRAPHY (CT) SCAN SITE OF CARE
UnitedHealthcare Commercial Utilization Review Guideline MAGNETIC RESONANCE IMAGING (MRI) AND COMPUTED TOMOGRAPHY (CT) SCAN SITE OF CARE Guideline Number: URG-13.01 Effective Date: February 1, 2019 Table
More informationCARECORE NATIONAL QUALITY STANDARDS DIAGNOSTIC IMAGING
CARECORE NATIONAL QUALITY STANDARDS DIAGNOSTIC IMAGING Diagnostic imaging is an integral component of our health care system utilized by all physician specialties for timely accurate diagnosis and treatment
More informationDelineation of Privileges Department of Internal Medicine Division of Cardiovascular Medicine
Delineation of Privileges Department of Internal Medicine Division of Cardiovascular Medicine Name: Please Print or Type LEVEL I CORE PRIVILEGES General Medicine: To qualify for the subspecialty of Cardiovascular
More informationAdult Cardiology Clinical Privileges
Name: Effective from / / to / / Initial privileges (initial appointment) (reappointment) Renewal of privileges All new applicants should meet the following requirements as approved by the governing body,
More informationscreening; 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 informationCodes 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 informationCertification Review. Module 28. Medical Coding. Radiology
Module 28 is the study of x-rays, using radiant energy and other imaging techniques, such as resonance imaging or ultrasound, to diagnose illnesses and diseases. Vocabulary Barium enema (BE): lower gastrointestinal
More informationSALZBURG WEILL CORNELL/NYPH SEMINAR. Diagnostic Imaging 3-Year Curriculum. YEAR 1 (i.e. 2015, 2018, 2021, 2024)
SALZBURG WEILL CORNELL/NYPH SEMINAR Diagnostic Imaging 3-Year Curriculum YEAR 1 (i.e. 2015, 2018, 2021, 2024) Course Directors: David W. Trost, MD, Franz Kainberger, MD Faculty: Gerd Bodner, MD, Marius
More informationDiagnostic 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 informationCPT 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 informationWe 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 information2012 CPT Radiology Codes Requiring Review Blue Cross and Blue Shield of Louisiana
2012 CPT Radiology Codes Requiring Review Blue Cross and Blue Shield of Louisiana CT Head 70480 CT orbit, sella or posterior fossa; w/o CT Head 70481 CT orbit, sella or posterior fossa; with CT Head 70482
More information05/02/ CPT Preauthorization Groupings Effective May 2, Computerized Tomography (CT) Abdomen 6. CPT Description SEGR CT01
Computerized Tomography (CT) 6 & 101 5 Upper Extremity 11 Lower Extremity 12 Head 3 Orbit 1 Sinus 2 Neck 4 7 Cervical Spine 8 Thoracic Spine 9 Lumbar Spine 10 Colon 13 CPT Preauthorization Groupings CPT
More informationAppendix A Residents and Fellows Cardiopulmonary Resuscitation (CPR) Certification Requirements by Program
Appendix A Residents and Fellows Cardiopulmonary Resuscitation (CPR) Certification Requirements by Program PROGRAM Type RESIDENT BLS ACLS PALS NRP ATLS Allergy & Immunology Fellow X X X Anesthesia Dentistry
More informationResidents should be able to understand the role of imaging-guidance to facilitate common radiological procedures.
Educational Goals & Objectives Internists provide continuing care for patients with a myriad of medical and psychosocial problems. During many patient encounters, the focus is on the diagnosis and treatment
More informationExamination: Type of examination: Description of the examination Price:
Examination: Type of examination: Description of the examination Price: Ultrasound / Sonographic examination/ Ultrasound examination of the upper abdominal area It is an examination of the liver, bile
More informationCLINICAL RADIATION SCIENCES (CLRS)
Clinical Radiation Sciences (CLRS) 1 CLINICAL RADIATION SCIENCES (CLRS) CLRS 101. Introduction to Clinical Radiologic Sciences. 1 Hour. Semester course; 1 lecture hour. 1 credit. Presentation and discussion
More informationADDITIONS. The following codes have been added.
ADDITIONS The following codes have been added. 99446 Interprofessional telephone/internet assessment and management service provided by treating/requesting physician or other qualified health care professional;
More informationClinical Privileges Profile Medical Imaging. Kettering Medical Center System
Printed Name Clinical Privileges Profile Kettering Medical Center System Kettering Medical Center Sycamore Medical Center Privileges are covered by an exclusive contract. Practitioners who are not a party
More informationFEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS
Tel: +27-21-9494060 Fax: +27-21-9494112 E-mail: leon.gouws@cancercare.co.za FEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS 1. EXTERNAL BEAM RADIATION... 2 2. PLANNING OF TREATMENT... 2 3. DELIVERY
More informationThyroid Cancer (Carcinoma)
Information for Patients Thyroid Cancer (Carcinoma) Prepared by the American Association of Clinical Endocrinologists (AACE), a not-for-profit national organization of highly qualified specialists in hormonal
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 informationDescription 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 informationLast 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 informationDiagnostic radiology
Practice area 159 Clinical PRIVILEGE WHITE PAPER Diagnostic radiology Background According to the American Board of Medical Specialties (ABMS), a radiologist is a physician who uses imaging methodologies
More informationCLINICAL PRIVILEGE WHITE PAPER
Vascular Procedure ultrasound 57 Procedure 57 CLINICAL PRIVILEGE WHITE PAPER Vascular ultrasound Background Vascular ultrasound is a noninvasive procedure used to diagnose and locate disorders of the vascular
More informationMOLINA HEALTHCARE OF MICHIGAN PRIOR AUTHORIZATION / PRE-SERVICE REVIEW GUIDE IMAGING CODES REQUIRING PRIOR AUTHORIZATION EFFECTIVE 1/1/2014
70336 MRI MRI, temporomandibular joint(s) 70450 CT/CTA CT, head or brain; without contrast material 70460 CT/CTA CT, head or brain; with contrast material(s) 70470 CT/CTA CT, head or brain; without contrast
More informationPHYSICIAN (MD/DO) Varies by specialty: $150,000-$700,000. University of Kentucky, University of Louisville, University of Pikeville
PHYSICIAN (MD/DO) Description A physician diagnoses and treats patients as part of the health care team. There are many different specialties in the career. Education Required Doctorate 8yr + Residency
More information***Self-Referrals do NOT apply to PEDIATRIC Patients***
THIPA has 3 types of Referrals: Self Referral Direct Referral Patient needs to be referred by their THIPA physician to see a Specialist or obtain a Test. This can be done by paper referral form, physician
More informationAIM 2014 CPT Radiology & Cardiac Codes Requiring Review
AIM 2014 CPT Radiology & Cardiac Codes Requiring Review Modality Body Part 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
More informationThe European Board of Urology
Page 1 of 15 The European Board of Urology Sub-specialty certification application: Prostate cancer, A - General information A1 - APPLICATION IDENTIFICATION 1a. Application code blank 1b. EBU internal
More informationSection 6 Ancillary Services
6Ancillary Services Laboratory..........................87 Radiology...........................91 Physical and Occupational Therapy......110 Acupuncture and Chiropractic Guidelines..113 Pharmacy..........................114
More information2010 Radiology Prior Authorization List for UnitedHealthcare s HealthChoice Members
70336 MR TEMPOROMANDIBULAR JOINT 70450 CT, HEAD OR BRAIN; WITHOUT MATERIAL 70460 CT HEAD/BRAIN W/ 70470 CT HEAD/BRAIN W/O & W/ 70480 CT, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MID 70481 CT ORBIT W/
More informationBlueAdvantage SM. & BlueChoice SM Radiology Prior Authorization Program Code List CPT /HCPS
BlueAdvantage SM & BlueChoice SM Radiology Prior Authorization Program Code List CPT /HCPS 70336 MRI TMJ 70450 CT Head Without Contrast 70460 CT Head With Contrast 70470 CT Head Without & With Contrast
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine
Specific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine American Osteopathic Association and American College of Osteopathic Internists BOT Rev. 2/2011 These
More informationUPMC 1 Delineation of Privileges Request Criteria Summary Sheet
UPMC 1 Facility: Specialty: UPMC Altoona Radiology KNOWLEDGE TRAINING Successful Completion of an ACGME/AOA, accredited program. The successful completion of an approved (ACGME/AOA) post graduate residency
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 informationAnthem 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 informationRoom 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.
More informationModule Six Evaluation of Infants
Module Six Evaluation of Infants Symptomatic Clinical Criteria: Liveborn infant with congenital microcephaly, or intracranial calcifications, or structural brain or eye abnormalities, or other congenital
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 informationContributors. Thanks to Peter Miller, MD; LCDR Kevin Preston, MD; and Keith Newbrough, MD for their generous contribution of images:
Contributors Thanks to Peter Miller, MD; LCDR Kevin Preston, MD; and Keith Newbrough, MD for their generous contribution of images: Peter Miller, MD, Indiana University School of Medicine Chapter 1: Figure
More informationDiagnostic Imaging Utilization Management and Consultation Management Programs Imaging Code Listing for Connecticut, Maine and New Hampshire
Diagnostic Imaging Utilization Management and Consultation Management Programs Imaging Code Listing for Connecticut, Maine and New Hampshire The grid below contains the CPT * codes that are subject to
More informationCPT Code Details
CPT Code 93572 Details Code Descriptor Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically
More informationRADIOLOGY PROGRAM TABLE OF CONTENTS. OVERVIEW. . Assessment... and... Certification
TABLE OF CONTENTS. OVERVIEW............................................................................................. 553..... Assessment............ and..... Certification..........................................................................
More informationLetter to the AMGA Board of Directors...1 Introduction...3
Table of Contents Letter to the AMGA Board of Directors...1 Introduction...3 Section I: Executive Summary Survey at a Glance...6 Participant Profile...10 Survey Methodology...18 How to Use This Report...21
More informationArterial Map of the Thorax, Abdomen and Pelvis 2017 Edition
Arterial Map of the Thorax, Abdomen and Pelvis Angiography 75605 (-26) Aortography, thoracic 75625 (-26) Aortography, abdominal by serialography 75630 (-26) Aortography, abdominal + bilat iliofemoral 75705
More informationCHAP9-CPTcodes _final doc Revision Date: 1/1/2016
CHAP9-CPTcodes70000-79999_final103115.doc Revision Date: 1/1/2016 CHAPTER IX RADIOLOGY SERVICES CPT CODES 70000-79999 FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES Current
More informationPrivileges for Zuckerberg San Francisco General Hospital
Requested Approved Applicant: Please initial the privileges you are requesting in the Requested column. Service Chief: Please initial the privileges you are approving in the Approved column. MedCardio
More informationBasics of Interventional Radiology Coding 2018
Basics of Interventional Radiology Coding 2018 Prepared and Published By: MedLearn Publishing A Division of MedLearn Media, Inc. 445 Minnesota Street, Suite 514 St. Paul, MN 55101 1-800-252-1578 medlearnmedia.com
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 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 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 informationNew Technology. New Technology. Summary. Data Collection. Hospital charge data used in APC grouping and payment
New Technology New Technology APCs not based on clinical aspects of services they contain New Technology APCs based on cost of items or services Procedures moved from New Technology APCs to clinical APCs
More informationRadiology Rotation Educational Goals & Objectives for Internal Medicine
Radiology Rotation Educational Goals & Objectives for Internal Medicine Internists provide continuing care for patients with a myriad of medical and psychosocial problems. During many patient encounters,
More informationJanuary 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 informationAMERICAN IMAGING MANAGEMENT
2012 CPT Codes Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o 74160 CT abdomen; with 74170 CT abdomen; w/o followed by Chest 71250 CT thorax; w/o 71260 CT thorax; with 71270
More informationAMERICAN IMAGING MANAGEMENT
2010 BCBS of Georgia CPT Codes With Grouper Numbers Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o contrast 6 74160 CT abdomen; with contrast 74170 CT abdomen; w/o contrast
More informationBCCCNP Service CPT Code FY 2019 Rate Oct 1, 2018 Dec 31, 2018
1 Screening Mammogram (Bilateral); including CAD Service CPT Code 77067 77067-TC 77067-26 $111.40 $81.32 $30.08 $131.51 $93.70 $37.82 * Note: Breast tomosynthesis, unilateral (77061) and bilateral (77062)
More informationLetter to the AMGA Board of Directors...1 Introduction...3
Table of Contents Letter to the AMGA Board of Directors...1 Introduction...3 Section I: Executive Summary Survey at a Glance...6 Participant Profile...10 Survey Methodology...18 How to Use This Report...21
More informationRADIOLOGIC TECHNOLOGY PROGRAM COURSE DESCRIPTIONS
RADIOLOGIC TECHNOLOGY PROGRAM COURSE DESCRIPTIONS Term I: Radiographic Procedures I (3 credits) This course is the first in a series of courses dealing with principals, techniques and radiographic procedures
More informationTable 1 ABMS MEMBER BOARDS APPROVED GENERAL CERTIFICATES
Table 1 ABMS MEMBER BOARDS APPROVED GENERAL CERTIFICATES A general certificate is the first certification awarded by a Member Board to candidates who meet the requirements for board certification in a
More informationDetailed Summary of the Proposed Rule for the Hospital Outpatient Prospective Payment System
Detailed Summary of the Proposed Rule for the Hospital Outpatient Prospective Payment System The Centers for Medicare and Medicaid Services (CMS) released its proposed rule for calendar year (CY) 2017
More informationTYPES OF DOCTORS. Dermatologist - This is a doctor that treats any ailment related to the skin and its appendages such as hair, nails etc.
Cardiologist - A cardiologist is certified to treat any problem dealing with heart diseases and cardiovascular diseases. Dentist - Any dental problem from tooth decay to dentures to retainers are handled
More informationBCCCNP Service CPT Code FY 2019 Rate Oct 1, 2018 Dec 31, 2018
1 Screening Mammogram (Bilateral); including CAD 2 Screening Breast Tomosynthesis (Bilateral) 3D Mammogram ** Can only be paid w/ screening mammography (77067))** 3 Diagnostic Mammogram (Unilateral); including
More informationDIAGNOSTIC IMAGING (DMI)
Diagnostic Imaging (DMI) 1 DIAGNOSTIC IMAGING (DMI) DMI 101 Introduction to Medical Imaging Introduction to Diagnostic Medical Imaging modalities with a special emphasis on Radiologic Technology and Diagnostic
More informationRADIOLOGY (Management)
ULTRASOUND BETA SCAN/ U/S ORBITAL 1600 Daily U/S WHOLE ABDOMEN (Abd + Pelvis) 1200 Daily U/S PELVIS 1200 Daily U/S ABDOMEN 1200 Daily U/S BREAST 1800 Daily U/S FOLLICULAR STUDY 3000 Daily U/S FOLLICULAR
More informationLetter to the AMGA Board of Directors... 1 Introduction... 3
Table of Contents Letter to the AMGA Board of Directors... 1 Introduction... 3 Section I: Executive Summary Survey at a Glance... 6 Participant Profile... 10 Survey Methodology... 19 How to Use This Report...
More information2015 Radiology Coding Survival Guide
2015 Radiology Coding Survival Guide Chapter 31: Clinical Brachytherapy (77750-77799) Clinical brachytherapy involves applying radioelements into or around a treatment field. CPT guidelines clarify that
More informationIntro: Slide 1. Slide 2. Slide 3. Basic understanding of interventional radiology. Gain knowledge of key terms and phrases
Slide 1 Intro: PRESENTED BY: Selena M. Moore, AAS, CCS, CPC HIMS Physician Liaison Coder This is a modified/updated presentation that was originally written by: Rosemary Waligorski, RHIT, CCS, RCC and
More informationEXAMS_ 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 informationLetter to the AMGA Board of Directors... 1 Introduction... 3
Table of Contents Letter to the AMGA Board of Directors... 1 Introduction... 3 Section I: Executive Summary Survey at a Glance... 6 Participant Profile... 10 Survey Methodology... 19 How to Use This Report...
More informationCLINICAL RADIATION SCIENCES, BACHELOR OF SCIENCE (B.S.) WITH A CONCENTRATION IN RADIOGRAPHY (DEGREE COMPLETION)
Clinical Radiation Sciences, Bachelor of Science (B.S.) with a concentration in radiography (degree completion) 1 CLINICAL RADIATION SCIENCES, BACHELOR OF SCIENCE (B.S.) WITH A CONCENTRATION IN RADIOGRAPHY
More informationINITIAL CLINICAL PRIVILEGES DELINEATION FORM Department of Medicine Monmouth Medical Center
INITIAL CLINICAL PRIVILEGES DELINEATION FORM Monmouth Medical Center Physician Name: Application Date: DIRECTIONS TO APPLICANTS: 1) GENERAL AND SPECIFIC PRIVILEGES: General Privileges: If you are requesting
More information