Articles - Page 2380

Do not report E Codes as primary Diagnosis – New Instructions

CMS provides new instructions to return as unprocessable claims submitted on the Form CMS-1500 where an ICD-9-CM “E” Code (external...

Ultraviolet Modality (CPT 97028)

Information for CPT 97028 is as follows. Photons in the ultraviolet (UV) spectrum are more energetic than those in the...

Obama Admin Issues New Rules To Cut Red Tape For Doctors & Hospitals

Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the release of a new rule will cut red tape...

CPT Code G0281 & CPT Code G0282 (2021)

For services performed on or after April 1, 2003, Medicare will cover electrical stimulation for the treatment of wounds only...

Can We Bill E/M & AWV On The Same Date?

Medicare will pay for a significant, separately identifiable medically necessary E/M service (Current Procedural Terminology CPT codes 99201 – 99215)...

Coverage Of Medically Necessary Supplies Used For TENS & NMES

Transcutaneous Electrical Nerve Stimulation (TENS) and/or Neuromuscular Electrical Stimulation (NMES) can ordinarily be delivered to patients through the use of...

Medicaid will not pay a crossover claim

Medicare has paid the claim in an amount that equals or exceeds Medicaid’s fee for the specified service; The combined...

Electrical Stimulation for Indications Other Than Wound Care (G0283)

Electrical stimulation for indications other than wound care is considered medically necessary when performed as an integral part of the...

Principles for Medicare Risk Adjustment

The CMS-HCC risk adjustment model is prospective—it uses demographic information (age, sex, Medicaid dual eligibility, disability status) and a profile...

Documentation is required when billing modifier 24

Based on three recent widespread probes of office evaluation and management (E/M) services, First Coast Service Options (FCSO) has discovered...

Intensive Behavioral Therapy (IBT) for Obesity

Effective with dates of service on or after November 29, 2011, Medicare covers IBT for obesity,defined as a body mass...

Two Hospital Visits on a same Day

Two Hospital Visits Same Day by the same physician Contractors pay a physician for only one hospital visit per day...