Medicare coverage for Physical Examination services

Medicare coverage for Physical Examination services

Effective Jan 1, 2011 Medicare would cover Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS) Medicare already covers “Welcome to Medicare” physical exam within the first 12 months for Part B beneficiaries that includes a one-time review of health, education and counseling about preventive services, and referrals for other care if needed. CPT…

Updated New CPT Codes For 2011

Updated New CPT Codes For 2011

Evaluation and Management – 3 New CPT Codes 2011 CPT 99224 – Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: Problem focused interval history Problem focused examination Medical decision making that is straightforward or of low complexity. Counseling and/or coordination…

Florida BCBS bundling edits

Florida BCBS bundling edits

BCBSF uses the following code-editing logic; please note that this is a listing of all customized edits from the standard recommended code editing logic. This does not represent a complete list of all procedure code edits. For more information please visit bcbsfl.com Code 76376 will not be separately reimbursed when submitted with the following: 70450 70460…

Requirements For Diagnostic X-Ray, Laboratory & Other Diagnostic Tests

Requirements For Diagnostic X-Ray, Laboratory & Other Diagnostic Tests

CMS describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for a Medicare beneficiary who is not a hospital inpatient or outpatient. Section 410.32(b) of the Code of Federal Regulations (CFR) requires that diagnostic tests covered under Sec.1861(s)(3) of the Act and payable under the physician fee schedule, with…

HCPCS level III Codes

HCPCS level III Codes

HCPCS level 3 codes came in to existence not before the year 2003. HCPCS level III codes are considered only as local codes and are not nationally accepted. These codes represent an item or service which is not included in the HCPCS level I and level II codes. Normally these codes would starts with an…

CPT – Category II Codes (2021)

Current Procedural Terminology (CPT) Category II codes contains a set of supplemental tracking codes for performance measurement and in turn decrease the need for record abstraction and chart review to minimize administrative burden on physicians, other health care professionals, hospitals and entities seeking to measure the quality of patient care. These codes do not serve…