MO HealthNet contact information for provider enrollment
PROVIDER COMMUNICATIONS573-751-2896MO HealthNet providers can contact the Provider Communications Unit with inquiries, concerns or questions regarding proper claim filing, claims resolution and...
View ArticleICD 10 code for osteopenia
Provider Action NeededThe Centers for Medicare & Medicaid Services (CMS) will implement Change Request (CR) 9252 on January 4, 2016, effective October 1, 2015. (See related MLN Matters® article...
View ArticleExample of billable and non billable prolonged service - CPT CODE 99358 & 99359
Examples of Billable Prolonged ServicesEXAMPLE 1A physician performed a visit that met the definition of an office visit code 99213 and the total duration of the direct face-to-face services (including...
View ArticlePolicy guideline for CPT CODE G0372 & 99360
Power Mobility Devices (PMDs)Section 302(a)(2)(E)(iv) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) sets forth revised conditions for Medicare payment of Power...
View ArticleCPT CODE P3000, P3001 , 85060, 38220, 85097 AND 86078
Specific Hematology, Cytopathology and Blood Banking ServicesCytopathology services include the examination of cells from fluids, washings, brushings or smears, but generally excluding hematology....
View ArticleBilling Clinical Consultation Services - 80500, 80502
Clinical consultations are paid under the physician fee schedule only if they:a. Are requested by the patient’s attending physician;b. Relate to a test result that lies outside the clinically...
View ArticleCost share and Collection process
What is Cost Sharing?Cost sharing is the patient balance that remains after the insurance plan has applied payment for covered services according to the benefit plan.What does it include?Cost Sharing...
View ArticleICD 10 code for Knee, abdominal pain
ICD 10 CODE FOR Knee PainICD-9-CM for Knee Pain is 719.46. Convert to ICD-10-CM is M25.569 Pain in unspecified knee. Arthralgia (joint pain) of lower leg.M25.561 - Pain in right kneeM25.562 - Pain in...
View ArticleICD CODE - Anemia, Hemolytic Anemia, Deficiency Anemia - D64.9
ICD 9 and ICD 10 code for AnemiaICD-9-CM 285.9 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 285.9 should only be used for claims with a date of...
View ArticleCPT CODE 98960 AND 98961. 98962
CPT CODE AND Description98960 - Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient...
View ArticleIdentifying Physician Scarcity Area Locations - Modifier AR
The CMS shall provide to the standard systems and carriers a file of zip codes for the automated payment of the primary care and specialty physician scarcity bonus. The file will be effective for...
View ArticleCPT CODE 38220, 38221, G0364 - Bone Marrow
CPT code and description38220 - Bone marrow; aspiration only - Average fee amount - $150 - $20038221 - Bone marrow; biopsy, needle or trocar - Average fee amount - $150 - $200DESCRIPTIONBone marrow...
View ArticleCPT CODE 99391, 99395, 99396 AND 99397 - Preventive Exam
CPT CODE AND Description99391 - Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination,...
View ArticleDefinition and terms of Teaching Physician Services
DefinitionsFor purposes of this section, the following definitions apply.Resident - An individual who participates in an approved graduate medical education (GME) program or a physician who is not in...
View ArticleICD 10 CODE - UTI and back pain
UTI is URINARY TRACT INFECTION (UTI), ICD 9 - 599.0 Urinary tract infection, site not specifiedMore specific ICD-10 choices include:ICD 10 CODEO23.3 Infections of other parts of urinary tract in...
View ArticleICD 10 code for hyperlipidemia - E78.5
HyperlipidemiaHyperlipidemia (hyperlipemia) involves abnormally elevated levels of any or all lipids and/or lipoproteins in the blood. Hyperlipidemias may basically be classified as either familial...
View ArticleICD 10 code for chest pain - R07.9
Chest pain, unspecified. R07.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.R07.9 - Chest pain, unspecifiedChest pain Other (anterior)...
View Article1199SEIU Benefit Funds - Claim submission address
Claims Submission• Electronic claims, using Payer ID #13162:Emdeonwww.Emdeon.com(800) 845-6592MD On-Linewww.1199MDOL.com(888) 499-5465Capario (formerly MedAvant)www.Capario.com(800) 792-5256We also...
View ArticleShoulder Pain ICD 9 & ICD 10 code - 719.41 , M25.51
Shoulder Pain ICD 9ICD-9-CM Diagnosis Code 719.41.Pain in joint, shoulder region.Short description: Joint pain-shlder.ICD-9-CM 719.41 is a billable medical code that can be used to indicate a diagnosis...
View ArticleVidant medical center - Hospital , Facility - Review.
HospitalThe Vidant medical center (deriving its name from the Latin word vi and Spanish word vida that both mean life), is a hospital located in Greenville, North Carolina. It is basically a primary...
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