Q4121 (Theraskin) Coding Guidelines
Theraskin can be reported with the Q4121 CPT code and billed per square centimeter. Documentation and medical necessity is required....
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Hardship Codes and Hardship Exemption Requests to avoid eRx penalties
CMS may exempt individual eligible professionals and group practices participating in the eRx GPRO from the 2013 payment adjustment if...
Primary Care Incentive Payment Program (PCIP)
According to Section 5501(a) of the Affordable Care Act the Primary Care Physicians (PCP) and NPPs who furnish specified primary...
Auto Denial of Claims Submitted With a GZ Modifier
The Health and Human Services Office of General Counsel (OGC) has provided guidance that Medicare contractors that process both institutional...
Reporting Epidural Or Subarachnoid Injections With Anesthesia Services
CPT codes 62310 – CPT 62311 and CPT 62318-62319 (Epidural or subarachnoid injections of diagnostic or therapeutic substance) may be...
Holding of claims containing procedure codes 33249 and C1882
The procedure-to-device edit files included in the January 2012 (V13.0) and April 2012 (V13.1) integrated outpatient code editor (I/OCE) do...
Reporting Ventilation Management / CPAP Services With Anesthesia
CPT codes 94002-94004, CPT code 94660-94662 (Ventilation management/CPAP services) If these services are performed during a surgical procedure, they are...
Physician Assistants Can Perform SNF Level of Care Re/Certifications
According to ‘Change Request 7701’ Physician Assistants can Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertifications. CR7701...
HHS PROPOSES ONE-YEAR DELAY OF ICD-10 COMPLIANCE DATE
The Department of Health and Human Services (HHS) announced a proposed rule that would delay, from October 1, 2013 to...
Documentations Requirements for Boniva, Zometa, Reclast, Prolia and Xgeva
Bisphosphonate therapy:The following bisphosphonate injections (administered IV) are considered medically reasonable and necessary when administered as outlined below. The coverage...
Medicaid Reimbursement for Adult Dental Services
Medicaid reimburses for adult dental services rendered by licensed, Medicaid-participating dentists. Medicaid reimbursable adult dental services are provided to recipients...
General Documentation Guidelines for Teaching Physicians and Residents
Both residents and teaching physicians may document physician services in the patient’s medical record. The documentation must be dated and...