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...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is performed to remove complex or ill-defi...
-
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...
-
Definition: The “-59” modifier is used to indicate a distinct procedural service. The physician may need to indicate that a procedure or...
-
Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would...
-
This procedure may be medically necessary for training patients whose walking abilities have been impaired by neurological, muscular, o...
-
Sentinel lymph node identification and biopsy typically involves a multidisciplinary approach. A nuclear medicine procedure called lymph...
-
AAPC’s Certified Professional Coder (CPC) credential is the gold standard for medical coding in physician office settings and held by more ...
