Featured Post
AMA approves E&M documentation changes
The AMA CPT Editorial Panel has approved revised guidelines for new and established office or outpatient visit codes 99202-99215 that woul...
Instructions for Billing of Monthly Home Dialysis MCP services
Effective January 1, 2011, the MCP (Monthly Capitation Payment) physician (or practitioner) must furnish at least one face-to-face patient visit per month for the home dialysis MCP service as described by CPT codes 90963, 90964, 90965, and 90966 shown in the following table. Documentation by the MCP physician (or practitioner) should support at least one face-to-face encounter per month with the home dialysis patient. However, Medicare contractors may waive the requirement for a monthly face-to-face visit for the home dialysis MCP service on a case by case basis; for example, when the nephrologist’s notes indicate that the physician actively and adequately managed the care of the home dialysis patient throughout the month.
When billing MCP services for a home dialysis patient who remained on home dialysis the entire month including at least one face-to-face visit, use the appropriate code from this series:
90963 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90964 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90965 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90966 End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 20 years of age and older
Reference: http://www.cms.gov/MLNMattersArticles/downloads/MM7003.pdf
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
CIGNA covers chiropractic manipulation and adjunct therapeutic procedures/modalities (e.g., mobilization, therapeutic exercise, traction) ...
-
An OPPS payment status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the H...
-
Urgent Care Centers are the Facilities that delivers Outpatient Medical Care usually for the conditions that does not require Hospital a...
-
Health benefit payers, including Medicare, are limited to use of those internal and external code sets identified in the implementation gui...
-
CMS is extending the deadline for eligible professionals (EPs) to submit eligibility appeals under the Medicare Electronic Health Record (E...
-
Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve ...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Sentinel lymph node identification and biopsy typically involves a multidisciplinary approach. A nuclear medicine procedure called lymph...
-
CIGNA will adopt a common time frame for health care professionals to follow for submitting claims to CIGNA. Except where state law requir...