CR11137 revises Chapter 13 of the Medicare Claims Processing Manual to allow providers to bill E/M codes 99211, 99212, and 99213 for Levels I through III effective from January 1, 2019, when performed with superficial radiation treatment delivery (up to 200 kV), when performed for the purpose of reporting physician work associated with,
- Radiation therapy planning
- Radiation treatment device construction
- Radiation treatment management when performed on the same date of service as superficial radiation treatment delivery.
According to Current Procedural Terminology (CPT) guidance, providers should not report superficial radiation (up to 200 kV) with CPT codes for planning and management.
Billing of these E/M codes with modifier 25 may be necessary if National Correct Coding Initiative (NCCI) edits apply.
Source: Revised
E/M Guidelines for Superficial Radiation Treatment
Blogger Widget
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
An OPPS payment status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the H...
-
Claim Adjustment Reason Codes (CARC) CO-22 or PR-22 This care may be covered by another payer per coordination of benefits. CO-19 This is...
-
Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve ...
-
Health benefit payers, including Medicare, are limited to use of those internal and external code sets identified in the implementation gui...
-
Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is performed to remove complex or ill-defi...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would...
-
CIGNA will adopt a common time frame for health care professionals to follow for submitting claims to CIGNA. Except where state law requir...
-
Sentinel lymph node identification and biopsy typically involves a multidisciplinary approach. A nuclear medicine procedure called lymph...
