Coding and Payment Guide for Anesthesia Services. An essential coding, billing, and reimbursement resource for anesthesiology and pain management
|
|
- Hector Gray
- 5 years ago
- Views:
Transcription
1 Coding and Payment Guide for Anesthesia Services An essential coding, billing, and reimbursement resource for anesthesiology and pain management
2 Contents Introduction... 1 Coding Systems... 1 Claim Forms... 2 Contents and Format of This Guide... 2 The Reimbursement Process... 3 Coverage Issues... 3 Payer Types... 3 Payment Methodologies... 5 Calculating Costs Other Factors Influencing Payment Correct Coding Policies for Anesthesia Services Workers Compensation Documentation An Overview Methods of Documentation General Guidelines for Documentation Principles of Documentation Fraud and Abuse Compliance Action Plan Claims Processing What to Include on Claims Clean Claims The Health Insurance Portability and Accountability Act Processing the Claim The Appeals Process Medicare Benefit Notices The CMS-1500 Claim Form The Electronic Claim Completion...57 The UB-04 Claim Form...65 Procedure Codes for Anesthesia Services...69 Structure the of CPT Book...69 CPT Coding Conventions...69 Unlisted Procedures...69 Modifiers...70 Payment for Anesthesia Services...71 Payment for Surgical Services and Procedures...71 Global Surgery Packages...72 Bundled Services Anesthesia...73 Procedure Code Listing...75 CPT Index ICD-9-CM Index ICD-9-CM Coding Conventions Coding Neoplasms Manifestation Codes Official ICD-9-CM Guidelines for Coding and Reporting ICD-9-CM Codes Medicare Official Regulatory Information Glossary Appendix A: Surgical to Anesthesia Code Crosswalk CPT Base Units Index CPT codes only 2009 American Medical Association. All Rights Reserved. Coding and Payment Guide for Anesthesia Services iii
3 report these codes if they elect not to participate. Category II codes are alphanumeric, consisting of four digits followed by an F and should never be used in lieu of a category I CPT code. This series of codes is updated on a biannual basis (January 1 and July 1), with codes that are released becoming effective six months later (e.g., codes released on January 1 become effective July 1). Refer to the AMA CPT website at for the most recent listing. Category III of the CPT coding system contains temporary tracking codes for new and emerging technologies that are meant to aid in the collection of data on these new services and procedures. Indicated by four numeric digits followed by a "T, like category II codes, category III CPT codes are released twice a year (January 1 and July 1) and can be found on the on the AMA CPT website. RVUs are not assigned for these codes, and payment is made at the discretion of the local payer. Once implemented, a service described by a category III CPT code may eventually become a category I code. HCPCS Level II Codes HCPCS Level II codes are commonly referred to as national codes or by the acronym HCPCS (Healthcare Common Procedure Coding System, pronounced hik-piks). HCPCS codes are used to bill Medicare and Medicaid patients and are also used by some third-party payers. HCPCS Level II codes, periodically updated and published annually by CMS, are intended to supplement the CPT coding system by including codes for nonphysician services, durable medical equipment (DME), and office supplies. These Level II codes consist of one alphabetic character (A through V) followed by four numbers. Claim Forms Institutional (facility) providers use the UB-04 claim form, also known as the CMS-1450, or the electronic 837i format to file a Medicare Part A claim to Medicare fiscal intermediaries (FI). Noninstitutional providers and suppliers (private practice or other health care providers offices) utilize the CMS-1500 form or the 837p electronic format to submit claims to Medicare contractors for Medicare Part B covered services. Medicare Part A coverage includes inpatient hospital, skilled nursing facilities (SNF), hospice, and home health. Medicare Part B coverage provides payment for medical supplies, physician, and outpatient services. Not all services rendered by a facility are inpatient services. Providers working in facilities routinely render services on an outpatient basis. Outpatient services are provided in settings that include rehabilitation centers, certified outpatient rehabilitation facilities, SNFs, and hospitals. Outpatient and partial hospitalization facility claims might be submitted on either a CMS-1500 or UB-04, depending on the payer. For professional component billing, most claims are filed using ICD-9-CM diagnosis codes to indicate the reason for the service, CPT codes to identify the service provided, and HCPCS Level II codes to report supplies on the CMS-1500 paper claim or the 837p electronic format. Contents and Format of This Guide The first three chapters following this introduction provide information regarding the reimbursement process, documentation, and claim completion, respectively. The fifth chapter, Procedure Codes for Anesthesia Services, contains a numeric listing of procedure codes. Each page identifies the information associated with that procedure including an explanation of the service, coding tips, associated diagnoses, related terms, Centers for Medicare and Medicaid Services (CMS) internet-only manual references that identify any official references found in the online CMS Manual System. The full excerpt from the online CMS Manual System pertaining to the reference is provided in the Medicare official regulatory chapter. The procedure code pages also have a list of codes from the official Centers for Medicare and Medicaid Services National Correct Coding Policy Manual for Part B Medicare Contractors that are considered to be an integral part of the comprehensive or mutually exclusive and should not be reported separately. Finally, all relative value information relevant to the code is listed at the bottom of the page. Following this chapter you will find a CPT procedure code index, an index of ICD-9-CM diagnosis codes for anesthesia services, and an index of HCPCS Level II codes for anesthesia services. Medicare Official Regulatory Information The full excerpts from the online online CMS Manual System pertaining to anesthesia are provided in this section. Since these excerpts often do not identify the guideline with corresponding CPT or HCPCS Level II codes our experts have crosswalked the appropriate reference, wherever possible, to the applicable procedure or supply code. This crosswalk reference is listed under each applicable CPT or HCPCS code in the definitions, guidelines, and index section. The excerpts are listed in this section in numeric order. Index and Appendixes The final section consists of a comprehensive index that provides a list of pages on which each term is discussed, and a glossary of coding, billing, and clinical terms applicable to your specialty. A listing of the Correct Coding Initiative (CCI) edits is provided to correspond with all of the CPT codes in the CPT definitions and guidelines section. CPT codes only 2009 American Medical Association. All Rights Reserved. 2 Introduction Coding and Payment Guide for Anesthesia Services
4 Anesthesia for procedures on salivary glands, including biopsy Coding Tips The appropriate modifier indicating the type of provider (i.e., physician, CRNA) as well as the type of service being rendered (i.e., personally performed, medical direction) should be appended to the procedure code. Modifiers indicating the physical status of the patient should also be appended when required by the third-party payer. Note that Medicare does not recognize physical status modifiers. Terms To Know biopsy. Tissue or fluid removed for diagnostic purposes through analysis of the cells in the biopsy material. ICD-9-CM Diagnostic Codes Malignant neoplasm of parotid gland Malignant neoplasm of submandibular gland Malignant neoplasm of sublingual gland Malignant neoplasm of other major salivary glands Malignant neoplasm of salivary gland, unspecified Malignant neoplasm of floor of mouth, part unspecified Secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck Secondary malignant neoplasm of other specified sites Benign neoplasm of major salivary glands Benign neoplasm of floor of mouth Benign neoplasm of other and unspecified parts of mouth Carcinoma in situ of lip, oral cavity, and pharynx Neoplasm of uncertain behavior of major salivary glands Neoplasm of uncertain behavior of lip, oral cavity, and pharynx Neoplasm of uncertain behavior, site unspecified Neoplasm of unspecified nature of digestive system Symptomatic inflammatory myopathy in diseases classified elsewhere (Code first underlying disease: 135, , , 446.0, 710.0, 710.1, 710.2, 714.0) Lung involvement in other diseases classified elsewhere (Use additional code to identify infectious organism. Code first underlying disease: 135, , 710.0, 710.2, 710.4) Hypertrophy of salivary gland Sialoadenitis Abscess of salivary gland Fistula of salivary gland Sialolithiasis Mucocele of salivary gland Disturbance of salivary secretion Other specified diseases of the salivary glands Cellulitis and abscess of oral soft tissues Work Value Non-Fac PE Fac PE V41.5 Sicca syndrome Congenital fistula of salivary gland Swelling, mass, or lump in head and neck Enlargement of lymph nodes Dysphagia, unspecified Dysphagia, oral phase Dysphagia, oropharyngeal phase Dysphagia, pharyngeal phase Dysphagia, pharyngoesophageal phase Other dysphagia Open wound of cheek, complicated Open wound of face, other and multiple sites, complicated Open wound of buccal mucosa, without mention of complication Open wound of mouth, other and multiple sites, without mention of complication Open wound of buccal mucosa, complicated Open wound of mouth, other and multiple sites, complicated Late effect of open wound of head, neck, and trunk Posttraumatic wound infection not elsewhere classified Persistent postoperative fistula, not elsewhere classified Problems with smell and taste IOM References 100-4,12,140; 100-4,12,140.2; 100-4,12, ; 100-4,12,30; 100-4,12,50; 100-4,3,100.2; 100-4,4,10.10; 100-4,4,10.4; 100-4,4,10.5; 100-4,4, ; 100-4,4, CCI Version T-0179T, 0180T, 01996, 31505, 31515, 31527, 31622, 31645, 36000, , , , 36440, 36600, 36640, 43752, 61026, 61055, , , , , 64470, 64475, 64479, 64483, , 64565, 67500, 76998, 81000, , 81005, 81015, 82013, 82205, 90865, 91000, 91055, 91105, , 92543, , , , , , , 93351, 93501, , 93701, , , 94002, 94004, 94200, 94250, 94640, 94644, , , , , 95819, 95822, 95829, , 96360, 96365, , , 99150, , , , 99315, 99318, , , , , , 99466, , C8921-C8927, G0380-G0384 Note: These CCI edits are used for Medicare. Other payers may reimburse on codes listed above. Malpractice Non-Fac Total Fac Total CPT only 2009 American Medical Association. All Rights Reserved. Coding and Payment Guide for Anesthesia Services Procedure Codes for Anesthesia Services 75
5 Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid epidural, cervical or thoracic epidural, lumbar, sacral (caudal) Explanation This procedure is performed to destroy nerve tissue or adhesions. The patient is placed in a spinal tap position. The site is sterilized, and the needle is inserted under fluoroscopic guidance. The needle is placed at the proper level and the neurolytic substance is administered. Once the injection/infusion is completed, the needle is removed and the wound dressed. Report if the substance is administered to the subarachnoid level. Report if the needle is inserted in the epidural region of a cervical or thoracic level. Report if the needle is inserted in the epidural region of a lumbar or sacral (caudal) level Disorders of sacrum Unspecified neuralgia, neuritis, and radiculitis IOM References 100-2,15,260; 100-4,12,30; 100-4,12,90.3; 100-4,14,10 CCI Version , 36000, , , 36440, 36600, 36640, 37202, 43752, , , , , 64479, 64483, , 69990, , 77002, , , 93318, 94002, 94200, 94250, , 94770, , 95819, 95822, 95829, 95955, 96360, 96365, 96372, , , Also not with 62280: 62284, , 64470, Also not with 62281: 62284, , 64470, 72275, J2001 Also not with 62282: , 62319, 64475, 72275, J2001 Note: These CCI edits are used for Medicare. Other payers may reimburse on codes listed above. Coding Tips As with all neurolytic injections, correct code assignment is dependent upon the type of injection. For this reason, the exact level and space of the injection should be verified in the medical record documentation. Injection of contrast is included and should not be reported separately. For fluoroscopic guidance and localization, see code Terms To Know adhesion. Abnormal fibrous connection between two structures, soft tissue or bony structures, that may occur as the result of surgery, infection, or trauma. dura mater. Outermost, hard, fibrous layer or membrane that surrounds the brain and spinal cord. subarachnoid. Located below the arachnoid meningeal layer. ICD-9-CM Diagnostic Codes Spasmodic torticollis (Use additional E code to identify drug, if drug-induced) Reflex sympathetic dystrophy of the lower limb Unspecified disorder of autonomic nervous system Multiple sclerosis Lumbosacral plexus lesions Lumbosacral root lesions, not elsewhere classified Causalgia of upper limb Mononeuritis multiplex Causalgia of lower limb Osteoarthrosis, unspecified whether generalized or localized, other specified sites Degeneration of lumbar or lumbosacral intervertebral disc Postlaminectomy syndrome, lumbar region Spinal stenosis of lumbar region Lumbago Sciatica Thoracic or lumbosacral neuritis or radiculitis, unspecified Work Value Non-Fac PE Fac PE Malpractice Non-Fac Total Fac Total Procedure Codes for Anesthesia Services CPT only 2009 American Medical Association. All Rights Reserved. Coding and Payment Guide for Anesthesia Services
ICD-9-CM Diagnosis Code options
ICD-9-CM Diagnosis Code options Diagnosis codes are used by both physicians and facilities to document the indication for the procedure. Intrathecal drug delivery is directed at managing chronic, intractable
More informationSample page. Anesthesia Services. Coding and Payment Guide
Coding and Payment Guide 2018 Anesthesia Services An essential coding, billing and reimbursement resource for anesthesiology and pain management POWER UP YOUR CODING with Optum360, your trusted coding
More informationPHYSICIAN CODING AND PAYMENT GUIDE
Targeted Drug Delivery PHYSICIAN CODING AND PAYMENT GUIDE 2018 Flowonix Medical has compiled this coding information for your convenience. This information is gathered from third party sources and is subject
More informationSample page. OMS An essential coding, billing and reimbursement resource for oral and maxillofacial surgery CODING & PAYMENT GUIDE
CODING & PAYMENT GUIDE 2019 OMS An essential coding, billing and reimbursement resource for oral and maxillofacial surgery Power up your coding optum360coding.com Contents Getting Started with Coding Guide...1
More informationJurisdiction Georgia. Retirement Date N/A
If you wish to save the PDF, please ensure that you change the file extension to.pdf (from.ashx). Local Coverage Determination (LCD): Surgery: Injections of the Spinal Canal (L32112) Contractor Information
More informationSample page. For the Physical Therapist An essential coding, billing and reimbursement resource for the physical therapist CODING & PAYMENT GUIDE
CODING & PAYMENT GUIDE 2019 For the Physical Therapist An essential coding, billing and reimbursement resource for the physical therapist Power up your coding optum360coding.com Contents Getting Started
More informationUltrasound Reimbursement Information for Anesthesiology 1
GE Healthcare Ultrasound Reimbursement Information for Anesthesiology 1 January, 2009 www.gehealthcare.com/reimbursement This overview addresses coding, coverage, and for ultrasound guidance with continuous
More informationCODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE
CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE Phone: 800-609-1108 Email: codmanpump@aol.com Fax: 303-703-1572
More informationReimbursement Information for Diagnostic Musculoskeletal Ultrasound and Ultrasound-guided Procedures 1
GE Healthcare Reimbursement Information for Diagnostic Musculoskeletal Ultrasound and Ultrasound-guided Procedures 1 January, 2013 www.gehealthcare.com/reimbursement This overview addresses coding, coverage,
More informationReimbursement Information for Ultrasound-guided Procedures Performed by Anesthesiologists 1
GE Healthcare Information for Ultrasound-guided Procedures Performed by Anesthesiologists 1 January, 2013 www.gehealthcare.com/reimbursement This overview addresses coding, coverage, and payment for ultrasound
More informationModifier 62 - Co-surgery (Two Surgeons)
Manual: Policy Title: Reimbursement Policy Modifier 62 - Co-surgery (Two Surgeons) Section: Modifiers Subsection: None Date of Origin: 1/1/2000 Policy Number: RPM035 Last Updated: 7/5/2017 Last Reviewed:
More informationPinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu
Search for: Search Search Icd 10 code for lumbar nerve root compression Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu 1-10-2017 Free, official coding info for 2018 ICD - 10 -CM S32 - includes
More informationJurisdiction New Mexico. Retirement Date N/A
Local Coverage Determination (LCD): Chiropractic Services (L34816) Contractor Information Contractor Name Novitas Solutions, Inc. opens in new Contract Number 04212 Contract Type A and B MAC J - H LCD
More informationBehavioral Health Services An essential, coding, billing and reimbursement resource for psychiatrists, psychologists, and clinical social workers
CODING & PAYMENT GUIDE 2019 Behavioral Health Services An essential, coding, billing and reimbursement resource for psychiatrists, psychologists, and clinical social workers Power up your coding optum360coding.com
More informationPhysician s Compliance Guide
Physician s Compliance Guide Updates to this guide will be posted on the Optum website and can be found at: http://www.optumcoding.com/product/updates/2013pcg/pcg13 Please use the following password to
More informationSample page. General Surgery/ Gastroenterology A comprehensive illustrated guide to coding and reimbursement CODING COMPANION. Power up your coding
CODING COANION 2019 General Surgery/ Gastroenterology A comprehensive illustrated guide to coding and reimbursement Power up your coding optum360coding.com Contents Getting Started with Coding Companion...i
More informationMP.098.MH Trigger Point and Transforaminal Epidural Injections
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.098.MH Trigger Point and Transforaminal Epidural Injections This policy applies to the following lines of business: MedStar Employee (Select) MedStar
More informationUltrasound and Fluoroscopic Paravertebral Facet Joint Injections
Policy Number FAC06222011RP Ultrasound and Fluoroscopic Approved By UnitedHealthcare Medicare Committee Current Approval Date 06/25/2014 IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable
More informationLocal Coverage Determination (LCD) for Chiropractic Services (L34816) (Posted for Notice)
Local Coverage Determination (LCD) for Chiropractic Services (L34816) (Posted for Notice) Print Contractor Information Contractor Name Novitas Solutions, Inc. Contractor Numbers 04911, 07101, 07102, 07201,
More informationWelcome to Nuvectra! We look forward to improving your solutions for patient needs. Nuvectra Connect Pre-Authorization Specialists
Our specialists are dedicated to supporting your team with all aspects of pre-authorization processes, case management, and reimbursement matters. We understand that patients come first, that s why we
More informationSAMPLE. Radiology Essential links from CPT codes to ICD-10-CM and HCPCS ICD-10. Cross Coder
Cross Coder www.optumcoding.com Radiology Essential links from CPT codes to ICD-10-CM and HCPCS 2017 a ICD-10 A full suite of resources including the latest code set, mapping products, and expert training
More informationSympathetic Electrical Stimulation Therapy for Chronic Pain
Sympathetic Electrical Stimulation Therapy for Chronic Pain Policy Number: 015M0076A Effective Date: April 01, 015 RETIRED 5/11/017 Table of Contents: Page: Cross Reference Policy: POLICY DESCRIPTION COVERAGE
More informationReimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Procedures Commonly Performed by Otolaryngologists
GE Healthcare Reimbursement Information for Diagnostic Ultrasound and Ultrasound-guided Procedures Commonly Performed by Otolaryngologists 1 January, 2013 www.gehealthcare.com/reimbursement imagination
More informationOP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN
Description of Measure OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN This measure calculates the percentage of MRI of the Lumbar Spine studies with a diagnosis of low back pain on the imaging claim and for
More informationIcd 10 degenerative joint disease back
Icd 10 degenerative joint disease back Search This article appeared in the January issue of the Radiology Coding & Compliance Expert. Many imaging studies are ordered because the patient is experiencing
More informationContractor Information. LCD Information. FUTURE Local Coverage Determination (LCD): Lumbar Epidural Injections (L33836)
FUTURE Local Coverage Determination (LCD): Lumbar Epidural Injections (L33836) Please note: Future Effective Date. Contractor Information Contractor Name Noridian Healthcare Solutions, LLC opens in new
More informationCD Horizon Spire. CD Horizon Spire Z PHYSICIAN REIMBURSEMENT REIMBURSEMENT GUIDE. Spinal System and. Spinal System
REIMBURSEMENT GUIDE CD Horizon Spire Spinal System and CD Horizon Spire Z Spinal System The CD Horizon Spire Plate is a posterior, single level, non-pedicle supplemental fixation device intended for use
More informationCERVICAL PROCEDURES PHYSICIAN CODING
CERVICAL PROCEDURES PHYSICIAN CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) Anterior interbody fusion, with discectomy and decompression; cervical below C2 22551 first interspace 22552
More informationMedStar Health considers Trigger Point and Transforaminal Epidural Injections medically necessary for the following indications:
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.098.MH Trigger Point and Transforaminal Epidural Injections This policy applies to the following lines of business: MedStar Employee (Select) MedStar
More informationLumify. Lumify reimbursement guide {D DOCX / 1
Lumify Lumify reimbursement guide {D0672917.DOCX / 1 {D0672917.DOCX / 1 } Contents Overview 4 How claims are paid 4 Documentation requirements 5 Billing codes for ultrasound: Non-hospital setting 6 Billing
More informationCODING COMPANION. Podiatry A comprehensive illustrated guide to coding and reimbursement. Sample page. Power up your coding optum360coding.
Podiatry A comprehensive illustrated guide to coding and reimbursement 2020 CODING COANION Power up your coding optum360coding.com Contents Getting Started with Coding Companion...i Resequencing of CPT
More informationSPINAL CORD STIMULATION FOR CHRONIC PAIN-TRUNK AND/OR LIMBS COMMONLY BILLED CODES EFFECTIVE JANUARY 2016
FOR CHRONIC PAIN-TRUNK AND/OR LIMBS EFFECTIVE JANUARY 2016 Medtronic provides this information for your convenience only. It does not constitute legal advice or a recommendation regarding clinical practice.
More informationSAMPLE. Behavioral Health Services
Coding and Payment Guide www.optumcoding.com Behavioral Health Services An essential coding, billing, and reimbursement resource for psychiatrists, psychologists, and clinical social workers 2017 a ICD-10
More informationAll Chiropractors and Chiropractic Clinics
P R O V I D E R B U L L E T I N B T 2 0 0 3 2 3 M A Y 1, 2 0 0 3 To: All Chiropractors and Chiropractic Clinics Subject: Overview The Office of Medicaid Policy and Planning (OMPP) has published new rules
More information4. ICD-10-PCS is used to code and classify data from hospital inpatient records only. a. diagnosis
1. The International Classification of Diseases (ICD) is published by the World Health Organization (WHO) and is used to classify data from death certificates. a. disease b. morbidity c. mortality d. procedure
More informationNeurostimulator Devices and Supplies
Neurostimulator Devices and Supplies Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................
More information2012 Head and Neck Reconstruction/ENT Repair Coding Observations
Health Policy, Economics & Reimbursement Reimbursement Hotline Tel: 888.543.3656 Fax: 866.262.6977 reimbursement@lifecell.com www.lifecell.com 2012 Head and Neck Reconstruction/ENT Repair Coding Observations
More informationNational Fee Analyzer. Charge data for evaluating fees nationally. Sample page. Power up your coding optum360coding.com
2019 National Fee Analyzer Charge data for evaluating fees nationally Power up your coding optum360coding.com Contents Introduction...1 Key to Proper Reimbursement... 1 The Medical Coding System... 1 What
More informationCPT 2015: Save Your Practice By Shaping Up Your Spinal Procedure Reporting
2015 Physician Coding Survival Guide CHAPTER 10: NEUROSURGERY CPT 2015: Save Your Practice By Shaping Up Your Spinal Procedure Reporting Sacroplasty codes will now be inclusive of imaging guidance. You
More informationReimbursement Information for Automated Breast Ultrasound Screening
GE Healthcare Reimbursement Information for Automated Breast Ultrasound Screening January 2015 www.gehealthcare.com/reimbursement The Invenia ABUS is indicated as an adjunct to mammography for breast cancer
More informationBack nerve impingement icd 10
Back nerve impingement icd 10 Approximate Synonyms. Clinical Information. A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may
More informationCoding Companion for General Surgery/ Gastroenterology. A comprehensive illustrated guide to coding and reimbursement
Coding Companion for General Surgery/ Gastroenterology A comprehensive illustrated guide to coding and reimbursement 2011 Contents Getting Started with Coding Companion...i Skin...1 Pilonidal Cyst...23
More informationCOMMONLY BILLED CODES SPINAL CORD STIMULATION FOR CHRONIC PAIN-TRUNK AND/OR LIMBS
COMMONLY BILLED CODES SPINAL CORD STIMULATION FOR CHRONIC PAIN-TRUNK AND/OR LIMBS EFFECTIVE JANUARY 2018 1 Medtronic provides this information for your convenience only. It does not constitute legal advice
More informationMEDICAL POLICY Acupuncture
POLICY: PG0382 ORIGINAL EFFECTIVE: 12/13/16 LAST REVIEW: 06/12/18 MEDICAL POLICY Acupuncture GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual
More informationEffective Date: 1/1/2019 Section: MED Policy No: 391 Medical Policy Committee Approved Date: 6/17; 12/18
Effective Date: 1/1/2019 Section: MED Policy No: 391 Medical Policy Committee Approved Date: 6/17; 12/18 1/1/2019 Medical Officer Date APPLIES TO: Medicare Only See Policy CPT/HCPCS CODE section below
More informationREPORTING POSTOPERATIVE PAIN PROCEDURES IN CONJUNCTION WITH ANESTHESIA
Committee of Origin: Economics (Approved by the ASA House of Delegates on October 17, 2007 and last updated on September 2, 2008) ASA has recently received reports of payers inappropriately bundling the
More informationIcd 9 lumbar radiculopathy
Icd 9 lumbar radiculopathy Search Short description: Lumbar disc displacement. ICD - 9 -CM 722.10 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however.
More informationCoding Companion for Neurosurgery/Neurology. A comprehensive illustrated guide to coding and reimbursement
Coding Companion for Neurosurgery/Neurology A comprehensive illustrated guide to coding and reimbursement 2011 Contents Getting Started with Coding Companion...i Skin...1 Repair...5 General Musculoskeletal...27
More informationCODING COMPANION. Sample page. Ophthalmology A comprehensive illustrated guide to coding and reimbursement. Power up your coding. optum360coding.
CODING COANION 2019 Ophthalmology A comprehensive illustrated guide to coding and reimbursement Power up your coding optum360coding.com Contents Getting Started with Coding Companion...i Resequencing of
More informationSample page. Laboratory Services. Coding and Payment Guide
Coding and Payment Guide 218 Laboratory Services An essential coding, billing and reimbursement resource for laboratory and pathology services POWER UP YOUR CODING with Optum36, your trusted coding partner
More informationUltrasound Reimbursement Guide 2015: BioJet Fusion
Ultrasound Reimbursement Guide 2015: BioJet Fusion Diagnosis codes explain the rationale for a given service and are a key factor in a payer s evaluation of medical necessity and coverage determination
More informationAnesthesia Top 50 Diagnoses (In Order of Usage) ~ 2014 ~
722.52 Degeneration of lumbar or lumbosacral M51.36 Other intervertebral disc generation lumbar intervertebral disc M51.37 Other intervertebral disc generation lumbosacral 721.3 Lumbosacral spondylosis
More informationReimbursement Guidelines for Pain Management Procedures 1
GE Healthcare Reimbursement Guidelines for Pain Management Procedures 1 April 2015 www.gehealthcare.com/reimbursement This overview addresses coding, coverage, and payment for pain management procedures
More informationSample page. Contents
CODING COMPANION 2018 Cardiology/ Cardiothoracic/ Vascular Surgery A illustrated guide to coding and reimbursement POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years. Visit optum360coding.com.
More informationKANSAS MEDICAL ASSISTANCE PROGRAM. Fee-for-Service Provider Manual. Rehabilitative Therapy Services
Fee-for-Service Provider Manual Rehabilitative Therapy Services Updated 12.2015 PART II (PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH/LANGUAGE PATHOLOGY) Introduction Section BILLING INSTRUCTIONS Page
More informationMedtronic ENT Transnasal Endoscopic Procedures Coding Guide. Effective January 1, 2009
Medtronic ENT Transnasal Endoscopic Procedures Coding Guide Transnasal Esophagoscopy Laryngeal Sensory Testing FEES FEEST Transnasal Fiberoptic Laryngoscopy Stroboscopy Disposable Sheaths Effective January
More informationABBOTT CODING GUIDE CHRONIC PAIN. Effective January 1, 2019 INTRO SPINAL CORD STIMULATION (SCS) RADIOFREQUENCY ABLATION (RFA)
ABBOTT CODING GUIDE CHRONIC PAIN Effective January 1, 2019 CHRONIC PAIN Effective January 1, 2019 Introduction The Chronic Pain Coding Guide is intended to provide reference material related to general
More informationReimbursement 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 informationH F 1 0 T H E R A P Y R E I M B U R S E M E N T R E F E R E N C E G U I D E
HF10 therapy, delivered by the Nevro Senza System, is the high-frequency spinal cord stimulation technology designed to aid in the management of chronic intractable pain of the trunk/limbs without paresthesia.
More informationMP.094.MH Transcutaneous Electrical Nerve Stimulators
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.094.MH Transcutaneous Electrical Nerve Stimulators This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP
More informationREIMBURSEMENT GUIDE. Sovereign. Spinal System
REIMBURSEMENT GUIDE Sovereign Spinal System REIMBURSEMENT GUIDE The Sovereign Spinal System is indicated for use with autogenous bone graft in patients with degenerative disc disease The Sovereign Spinal
More informationSample page. Primary Care, Pediatrics/ Emergency Medicine. A comprehensive illustrated guide to coding and reimbursement CODING COMPANION
CODING COMPANION 2018 Primary Care, Pediatrics/ Emergency Medicine A comprehensive illustrated guide to coding and reimbursement POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years.
More informationCoding Companion for Emergency Medicine. A comprehensive illustrated guide to coding and reimbursement
Coding Companion for Emergency Medicine A comprehensive illustrated guide to coding and reimbursement 2009 Contents Getting Started with Coding Companion... i Skin/Incision...1 Debridement...7 Excision...12
More informationEPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN
EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN UnitedHealthcare Oxford Clinical Policy Policy Number: PAIN 019.21 T2 Effective Date: October 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE...
More informationChiropractic 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 informationCoding Companion for Podiatry. A comprehensive illustrated guide to coding and reimbursement
Coding Companion for Podiatry comprehensive illustrated guide to coding and reimbursement 2016 Contents Contents Foot and Toes 28043-28045 [28039, 28041] 28043 28039 28045 28041 Excision, tumor, soft tissue
More informationRadiculopathy and lumbar pain icd 10 epidural injection
Radiculopathy and lumbar pain icd 10 epidural injection The Borg System is 100 % Radiculopathy and lumbar pain icd 10 epidural injection 24-5-2016. 16 Intervertebral disc disorder with radiculopathy, lumbar
More informationReimbursement 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 informationSmartMonitor Helpful for Filing
Apnea Monitor HCPCS E0618 or E0619 Overview The following information describes coverage and payment information regarding the use of the Circadiance SmartMonitor: Coding, coverage, payment, and documentation
More informationContractor Information. LCD Information. FUTURE Local Coverage Determination (LCD): Pain Management (L35033) Document Information
FUTURE Local Coverage Determination (LCD): Pain Management (L35033) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Please note: Future Effective Date.
More informationRadiculopathies Carpal tunnel syndrome Tarsal tunnel syndrome Trauma to nerves Motor/sensory deficits Hot/cold sensation Neuritis
Contact: Toll-free: 1-877-268-1346 Locals: 404-814-0161 Forms: www.pmdtesting.com NCVs aid in the evaluation of: Herniated Disks Peripheral neuropathies Numbness and tingling Pain in the extremities Atrophy
More informationCD Horizon Solera 5.5/6.0mm Fenestrated Screw Set
REIMBURSEMENT GUIDE CD Horizon Solera 5.5/6.0mm Fenestrated Screw Set DEVICE DESCRIPTION The CD Horizon Solera 5.5/6.0mm Fenestrated Screw Set consists of a variety of cannulated multi-axial screws (MAS)
More informationNeoplasms/Lymphoma/Leukemia
Neoplasms/Lymphoma/Leukemia Session Guidelines This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars monthly to address topics related to risk adjustment documentation and
More informationLow back pain, radiculopathy left leg icd 10 code
Home Search Low back pain, radiculopathy left leg icd 10 code 2018 ICD - 10 code for Radiculopathy is M54.1. Lookup the complete ICD 10 Code details for M54.1.. Low back pain ; M54.6 - Pain in thoracic
More informationPolicy Specific Section:
Payment Policy Anesthesia Services Type: Payment Policy Policy Specific Section: Payment Original Policy Date: Effective Date: October 1, 2010 06-16-2014 Description Anesthesia services consist of the
More information2017 Rhinoplasty Coding and Reimbursement Guide
2017 Rhinoplasty Coding and Reimbursement Guide Profile Costal Cartilage Allograft A Pre-shaped costal cartilage allograft for rhinoplasty procedures HCPCS Description * Status Indicator APC HOPPS¹ ASC¹
More informationCoding Companion for Plastics/OMS/Dermatology. A comprehensive illustrated guide to coding and reimbursement
Coding Companion for Plastics/OMS/Dermatology A comprehensive illustrated guide to coding and reimbursement Contents Getting Started with Coding Companion... i Skin...1 Nails...28 Pilonidal Cyst...32 Repair...33
More informationNational Imaging Associates, Inc. Clinical guidelines CHIROPRACTIC SERVICES. Original Date: Page 1 of FOR CMS (MEDICARE) MEMBERS ONLY
National Imaging Associates, Inc. Clinical guidelines CHIROPRACTIC SERVICES CPT4 Codes: Please refer to pages 2-10 LCD ID Number: L35424 Novitas: J-H: DC, DE, MD, NJ, PA J-L: AR, CO, LA, MS, NM, OK, TX
More information2018 Reimbursement Information for Mammography, CAD and Digital Breast Tomosynthesis 1
GE Healthcare 2018 Reimbursement Information for Mammography, CAD and Digital Breast Tomosynthesis 1 May 2018 www.gehealthcare.com/reimbursement This advisory addresses Medicare coding, coverage and payment
More informationCompliance Institute 2003
Compliance Institute 2003 The Fundamentals of Coding for Non-Coders and Potential Compliance Issues Related to Coding Activities April 29, 2003 Robert A. Pelaia, JD, CPC Associate General Counsel Director
More informationIcd 10 code for left radicular pain
Icd 10 code for left radicular pain cpt new description 64633 destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single.
More information2017 Coding and Reimbursement Survival Guide
2017 Coding and Reimbursement Survival Guide Chapter 14: Otolaryngology CPT 2017: Latest CPT Edition Offers New Code for Injection Laryngoplasty Changes could impact your reimbursement. The New Year is
More informationTracking of disease processes Classification of causes of mortality Medical research Evaluation of hospital service utilization
1 2 Learning Objectives Explain the reasons and importance of coding diagnoses. Describe the importance of matching the correct diagnostic code to the appropriate procedural code. Differentiate between
More informationICD-10-CM. International Classification of Diseases, 10th Revision, Clinical Modification
ICD-10-CM International Classification of Diseases, 10th Revision, Clinical Modification ICD-10 stands for the International Statistical Classification of Diseases and Related Health Problems, 10 th revision
More informationRADIATION THERAPY SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL
RADIATION THERAPY SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL APRIL 2018 CSHCN PROVIDER PROCEDURES MANUAL APRIL 2018 RADIATION THERAPY SERVICES Table of Contents 34.1 Enrollment......................................................................
More informationHow Many Sections Is The Cpt Manual Divided Into
How Many Sections Is The Cpt Manual Divided Into Vocabulary words for This is a review students can take as many times as they would like. 6. The CPT manual is divided into how many sections? Medicine
More informationThis Material is Copyright Protected
Proper Utilization of ICD-10 Codes in the Chiropractic Office Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO Certified Professional Compliance Officer (CPCO) Certified Medical Compliance Specialist (MCS-P)
More informationIcd 10 code for failed lumbar syndrome
Search Search Icd 10 code for failed lumbar syndrome 1-2-2001 Reader Question: Failed Back Syndrome such as a herniated lumbar disk (722.10).. ICD-10 Charts ; Code Connect With AMA CPT. 12-2-2016 I work
More informationCLINICAL MEDICATION POLICY
CLINICAL MEDICATION POLICY Policy Name: Opdivo (nivolumab) injection Policy Number: Approved By: Medical Management, Clinical Pharmacy Products: Highmark Health Options Application: All participating hospitals
More informationHerniated Disc Treatment Non-covered Procedures
Herniated Disc Treatment Non-covered Procedures Date of Origin: 03/2004 Last Review Date: 03/22/2017 Effective Date: 03/22/2017 Dates Reviewed: 02/2005, 02/2006, 02/2007, 03/2008, 01/2009, 04/2009, 02/2011,
More informationRadiation Therapy Services
Radiation Therapy Services Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................
More information2009 Pain Coding Update and Pain Industry Business Trends
2009 Pain Coding Update and Pain Industry Business Trends Linda Van Horn, MBA June 13, 2009 2009 Pain Coding Update and Pain Industry Trends Agenda 2009 CPT Coding Updates Pay For Incentives ICD-10 American
More informationLinks in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Texas. Retirement Date N/A
Local Coverage Determination (LCD): Chiropractic Services (L35424) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor
More informationIcd 10 code for low back pain with radiculopathy to legs
P ford residence southampton, ny Icd 10 code for low back pain with radiculopathy to legs WebMD experts and contributors provide answers to your health questions. Table: CPT Codes / HCPCS Codes / ICD -
More information2017 Reimbursement Information for Mammography, CAD and Digital Breast Tomosynthesis 1
GE Healthcare 2017 Reimbursement Information for Mammography, CAD and Digital Breast Tomosynthesis 1 February 2017 www.gehealthcare.com/reimbursement This advisory addresses Medicare coding, coverage and
More informationIcd 10 code for failed back surgery syndrome lumbar
Icd 10 code for failed back surgery syndrome lumbar Spinal stenosis can be a late complication after laminectomy for disc herniation or when surgery was performed for the primary pathologic condition of
More information2018 EAR, NOSE & THROAT (ENT) SURGERY MEDICARE REIMBURSEMENT CODING GUIDE
2018 EAR, NOSE & THROAT (ENT) SURGERY REIMBURSEMENT CODING GUIDE Effective January 1, 2018 Medicare National Average Rates and Allowables (Not Adjusted for Geography) PHYSICIAN 3 HOSPITAL OUTPATIENT 4
More information2018 HEMODIALYSIS CATHETERS CODING AND REIMBURSEMENT GUIDE
2018 HEMODIALYSIS CATHETERS CODING AND REIMBURSEMENT GUIDE Contents Overview of Central Venous Access s for Hemodialysis 2 Procedures Using Hemodialysis s 2 Physician Reimbursement for Hemodialysis s 3
More informationHF10 THERAPY 2018 Ambulatory Surgery Center Reimbursement and Coding Reference Guide
HF10 therapy, delivered by the Nevro Senza System, is the high-frequency spinal cord stimulation technology operated at 10,000 Hz designed to aid in the management of chronic intractable pain of the trunk
More informationICD-10 FOR NEUROSURGERY NERVES- Part II
ICD-10 FOR NEUROSURGERY NERVES- Part II J O H N F B I S H O P, P A - C, C P C, C P M A, C G S C, C P R C D I R E C T O R S U R G I C A L C O D I N G A N D A U D I T I N G S E R V I C E S S E N I O R M
More information