First Coast Service Options Inc. (First Coast) has discovered that claims containing Current Procedural Terminology (CPT®) code 95910 that were billed with either modifier 26… Read More »Incorrect denial of claims for procedure code 95910
Payment on a fee schedule basis is required for prosthetic devices by the Social Security Act, Section 1834(h). The following codes are being added to… Read More »2013 New HCPCS Code for External Ventricular Assist Devices or Any Ventricular Assist Device (VAD) For Which Payment Was Not Made Under Medicare Part A
The HIPAA Version 5010 implementation guide describes Non-Specific Procedure Codes as codes that may include, in their descriptor, terms such as: “Not Otherwise Classified (NOC);… Read More »HIPAA Version 5010 requires corresponding description of the procedures when reported using Unlisted CPT codes
An OPPS status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the HCPCS code is paid under… Read More »Payment Status Indicators for All CPT codes
Iontophoresis is a process in which electrically charged molecules or atoms (e.g., ions) are driven into tissue with an electric field. Voltage provides the driving… Read More »Iontophoresis (97033 CPT code)
Elastic bandages are those that contain fibers of rubber (latex, neoprene), spandex, or elastane. Roll bandages that do not contain these fibers are considered non-elastic… Read More »CPT codes for Elastic bandages
Codes A6448-A6450 describe ACE type elastic bandages A6448 Light compression bandage, elastic, knitted/woven, width less than 3 in, per yd A6449 Light compression bandage, elastic, knitted/woven, width… Read More »CPT code for ACE Bandage
The below list of code combinations that Humana has determined are not appropriately reported together with a modifier 59 and which differ from AMA CPT… Read More »Humana differ from AMA CPT Coding guidelines
Myocardial perfusion imaging is being done to determine the significance or the extent of myocardial ischemia (or scar), or to assess myocardial viability (e.g., risk… Read More »CPT 78451, CPT 78452, CPT 78453 & CPT 78454
Radiopharmaceuticals are used in the field of nuclear medicine as tracers in the diagnosis and treatment of many diseases. Many radiopharmaceuticals use technetium-99m (Tc-99m) which… Read More »Coding Guidelines and CPT codes for Radiopharmaceuticals