by Medical Billing | Nov 24, 2011 | CPT modifiers
HIPAA 4010 Cutoff Date Coming Soon All HIPAA-covered entities must be fully compliant with 5010 on January 1, 2012. Medicare, Wisconsin Physicians Service Insurance Corp. (WPS), TriWest Healthcare Alliance, and TRICARE® are in compliance with HIPAA 5010. If you fail...
by Medical Billing | Nov 21, 2011 | CPT modifiers
57 Modifier – Decision for surgery made within global surgical period E/M services on the day before major surgery or on the day of major surgery that result in the initial decision to perform the surgery are not included in the global surgery payment for the...
by Medical Billing | Nov 17, 2011 | CPT modifiers
24 Modifier Unrelated evaluation and management service by the same physician during a postoperative period Use modifier 24 when an E/M service is performed during a postoperative follow-up period for reasons unrelated to the original minor or major procedure....
by Medical Billing | Nov 14, 2011 | CPT modifiers
Examples of Proper Use of the 25 Modifier Example 1: A patient has a nosebleed. The physician performs packing of the nose in the office, which stops the bleeding. At the same visit, the physician then evaluates the patient for moderate hypertension that was not well...
by Medical Billing | Nov 11, 2011 | CPT modifiers
Modifier 25 – Significant, Separately Identifiable Service: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: It may be necessary to indicate that on the day a...
by Lori | Nov 8, 2011 | CPT modifiers
AI Modifier Definition – Principal Physician of Record: Effective for dates of service on or after January 1, 2010, modifier AI should be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who...
by Lori | Oct 27, 2011 | CPT modifiers
Procedure Code Description 2016 National Averages1 Facility Non-Facility 94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation $36.52 $36.52 94010 TC Technical...
by Lori | Oct 25, 2011 | CPT modifiers
30000 procedure codes that are “Nevers” for assistant surgeon The below table identified procedure codes that are not eligible for reimbursement when reported by an Assistant Surgeon. 30000 30930 31525 31633 33214 36100 36515 36861 38211 30020 31000 31526...
by Lori | Oct 23, 2011 | CPT modifiers
Stress Echocardiogram Procedures (ECHO procedure CODES) Echocardiogram CPT Description Stress Echo (SE) 93350 Transthoracic Stress Echo, complete 93351 Transthoracic Stress Echo, complete w...
by Medical Billing | Oct 21, 2011 | CPT modifiers
2011-2012 Billing for Flu Shots Upon direction from TRICARE Management Activity (TMA), TriWest Healthcare Alliance (TriWest) will be following the latest Centers for Medicare & Medicaid Services’ billing guidelines for the 2011-2012 flu season. The change is...
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