Home Prothrombin Time International Normalized Ratio (PT/INR) HCPCS code G0250 Coverage and Limitations

Home Prothrombin Time International Normalized Ratio (PT/INR) HCPCS code G0250 Coverage and Limitations

Long Description CPT G0250: Physician review, interpretation, and patient management of home INR testing for a patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes face-to-face verification by the physician that the patient uses the device in the context of the management of the anticoagulation therapy following initiation of the…

New Screening Codes

New Screening Codes

G0442 Annual alcohol misuse screening, 15 minutes G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes G0444 Annual depression screening, 15 minutes G0445 High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes G0446 Intensive behavioral therapy to reduce cardiovascular disease risk, individual,…

HCPCS codes G0442 and G0443 (2021)

HCPCS codes G0442 and G0443 (2021)

ffective for claims with dates of service October 14, 2011, and later, CMS would cover annual alcohol screening, and for those that screen positive, up to four, brief, face-to-face behavioral counseling interventions per year for Medicare beneficiaries, including pregnant women: • who misuse alcohol, but whose levels or patterns of alcohol consumption do not meet…

E Prescription

E Prescription

With effect from Jan 1, 2012, the description for ERx G-code, G8553 has been revised to “Prescription(s) generated and transmitted via a qualified eRx system or a certified EHR system“. Earlier it was ‘At least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system’. For successful reporting under…

How to bill for Incomplete Colonoscopies? Can we report CPT 45330 for incomplete colonoscopies?

How to bill for Incomplete Colonoscopies? Can we report CPT 45330 for incomplete colonoscopies?

The CPT code for incomplete colonoscopy is 45330. An incomplete colonoscopy, for example, the inability to extend beyond the splenic flexure, is billed and paid using colonoscopy code 45378 with modifier “-53.” The Medicare physician fee schedule database has specific values for code 45378-53. These values are the same as for code 45330, sigmoidoscopy, as…

Cardiac Resynchronization Therapy

Cardiac Resynchronization Therapy

Effective for services furnished on or after January 1, 2012, cardiac resynchronization therapy involving an implantable cardioverter defibrillator (CRT-D) will be recognized as a single, composite service combining implantable cardioverter defibrillator procedures (described by Current Procedural Terminology (CPT) code 33249 (Insertion or repositioning of electrode lead(s) for single or dual chamber pacing cardioverter-defibrillator and insertion of pulse generator))…

New and Deleted Q codes list

New and Deleted Q codes list

Added Q – Codes Q0162 Ondansetron 1 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q2043 Sipuleucel-T, minimum of 50 million autologous cd54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures,…

Evaluation and Management services – Revised code list

Evaluation and Management services – Revised code list

CPT 99218 Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of…

CPT code updates for Respiratory System

CPT code updates for Respiratory System

Newly added Thoracotomy CPT code list 32096 Thoracotomy CPT code, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral 32097 Thoracotomy CPT code, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral 32098 Thoracotomy CPT code, with biopsy(ies) of pleura 32505 Thoracotomy CPT code; with therapeutic wedge resection (eg, mass, nodule),…