by Medical Billing | Aug 24, 2018 | CPT modifiers
DENTAL BILLING:Dental services provided in the clinic setting (hospital or free-standing) are to be billed using the APG payment methodology. The only exception to this policy is orthodonture, which is to be billed to the dental practitioner fee schedule and not to...
by Medical Billing | Jun 16, 2018 | CPT modifiers
Corrections in the Medical Record If the original entry in the medical record is incomplete, contracting providers shall follow the guidelines below for making a correction, addendum, or amendment. Signature requirements as defined above apply to all corrections in...
by Medical Billing | May 18, 2018 | CPT modifiers
UTILIZATION REVIEW AND MEDICAL NECESSITY The contracting provider agreement requires providers to cooperate in utilization review and medical necessity determinations. Utilization review is the process of determining the appropriateness of services rendered to and...
by Medical Billing | Nov 13, 2017 | CPT modifiers
RESPITE BENEFIT Respite services provide limited and temporary relief for families caring for beneficiaries with complex health care needs when the care needs require nursing services in lieu of the trained caregivers. Services are provided in the family home by...
by Medical Billing | Oct 6, 2017 | CPT modifiers
INTERMITTENT NURSING VISITS/AIDE VISITS/THERAPIES Each visit must be reported on a separate claim line: Medicaid follows Medicare policy on the requirement that each home health agency visit (e.g., nursing, therapy) must be billed on an individual line. This policy...
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