How to use CCI edit when procedure denied as bundled service
If I receive a denial for a procedure bundled into another service, and I cannot find this code pair in the column 1/column 2 correct coding list of edits, where else should I look?Look in the mutually...
View ArticleCPT 99082 - Paymnet guide - Rural health clinic
Rural Health Clinic and Federally Qualified Health Center ServicesPayment may be made under Part B for the medical and other health services furnished by a qualified rural health clinic (RHC) and...
View ArticleCPT 81404, 81420, 81422, 00009M - Moleular pathology, Melanoma, Fetal aneupolidy
Code DescriptionCPT 81404 Molecular pathology procedure, Level 5 (eg, analysis of 2 - 5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6 -10 exons, or...
View ArticleCPT code 81334, 81432 - 81438, 0013U - Hereditary Breast cancer
Code Description CPT 0013U Oncology (solid organ neoplasia), gene rearrangement detection by whole genome next - generation sequencing, DNA, fresh or frozen tissue or cells, report of specific gene...
View ArticleCPT 0340T, 19105, 20983, 32994, 50250, 50542, 50593 - Cryosurgical ablation
Coding Code Description CPT0340T Ablation, pulmonary tumor(s), including pleura or chest wall when involved by tumor extension, percutaneous, cryoablation, unilateral, includes imaging guidance (code...
View ArticleCPT 95940, 95941, g0453 - intraoperative neuophysiology moniotoring
Coding Medically Necessary Code Description CPT95940 Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes...
View ArticleCPT 0359T, 0362T, 0363T, 0364T, 0365T, H2014, H0031 - Applied Behavior Analysis
Coding Code Description CPT0359T Behavior identification assessment – Used for initial evaluation/assessment, initial functional analysis, and periodic functional analysis re-assessments (must be done...
View ArticleCPT 81205, 81206, 81207, 81208 - Chronic mylogenous leukemia
Coding Code Description CPT81205 BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, Maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X)81206...
View ArticleCPT 22513, 22514, 22515- Percuaneous Vertebral augmentation
CodingIn 2015, the CPT codes combined the kyphoplasty procedure with all of the necessary imaging guidance; they are listed in the table below.Code Description CPT22513 Percutaneous vertebral...
View ArticleCPT 76120, 76125, 76496, 76499 - Dynamic spinal visualization
Coding Code Description CPT76120 Cineradiography/videoradiography, except where specifically included76125 Cineradiography/videoradiography to complement routine examination (list separately in...
View ArticleCPT 20974, 20975, E0747 - Electrical Bone Growth stimulator
Code Description CPT20974 Electrical stimulation to aid bone healing; noninvasive (non-operative)20975 Electrical stimulation to aid bone healing; invasive (operative)HCPCSE0747 Osteogenesis...
View ArticleCPT 0069U, 81229, 81327, 81407 - Miscellaneous Genetic and Molecular...
Code Description CPT 0069U Oncology (colorectal), microrna, rt-pcr expression profiling of mir-31-3p, formalinfixed paraffin-embedded tissue, algorithm reported as an expression score 81229 Cytogenomic...
View ArticleCSHCS - Covered Benifits, renewal of coverage
Covered BENEFITSCSHCS covers services that are medically necessary, related to the beneficiary’s qualifying diagnosis(es), and ordered by the beneficiary’s CSHCS authorized specialist(s) or...
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Submittig more than 12 ICD and supplemental DX code
The Centers for Medicare & Medicaid Services (CMS) requires all health plans to submit Health Insurance Portability and Accountability Act (HIPAA)-compliant 837 claims transactions to CMS for...
View ArticleCPT 81401, 81405, 81408, 81410, 81411 - Genetic Testing for Marfan Syndrome
Coding Code Description CPT 81401 MED12 (mediator complex subunit 12)(eg, FG syndrome type 1, Lujan syndrome), common variants (eg, R961W, N1007S) 81405 ACTA2 (actin, alpha 2, smooth muscle, aorta)...
View ArticleElectronic Bill Attachments - Basic requirments - WC claim and commercial
Electronic Bill Attachments(a)Required reports and/or supporting documentation to support a bill as defined in Complete Bill Section 3.0 shall be submitted in accordance with this section. Unless...
View ArticleMedicaid hospice, respite benefit - CSHCS
What Is Hospice Care?Medicaid participants can receive hospice care when they are terminally ill. “Terminally ill” means the patient has been diagnosed with a medical condition that reduces their life...
View ArticleMedicaid coverage on specaility dental, general dental
Medicaid Coverage of Dental Benefits for AdultsKey Points• Poor oral health is widespread among adults in the United States and especially affects those with low incomes.– Adults with incomes below 100...
View ArticleMedical billing specialist Job - Profile, skillset and duties
Lucrative career opportunities for medical billing specialistsWhen you think of large hospital networks, the first picture that comes to mind are doctors and nurses who are perhaps working relentlessly...
View ArticleCPT G0446. G0447, G0473 - Obesity counseling
CPT code and DescriptionG0446 – annual, face-to-face intensive behavioral counseling (IBT) for cardio-vascular disease (CVD), individual, 15 minutesG0447– face-to-face behavioral counseling for...
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