Revised payment methodology for anesthesiology claims submitted with Modifier GC

Teaching anesthesiologists rendering services in a Method II CAH (also referred to as CAHs that have elected the optional method) have the option of reassigning their billing rights to the CAH. When billing rights are reassigned, the Method II CAH submits an 85x bill type with revenue code 0963 (professional fees for Anesthesiologist (MD)) for…

Sleep Disorder Clinics – Coverage for Narcolepsy, Sleep Apnea, Impotence and Parasomnia

Sleep Disorder Clinics – Coverage for Narcolepsy, Sleep Apnea, Impotence and Parasomnia

Sleep disorder clinics are facilities in which certain conditions are diagnosed through the study of sleep. Such clinics are for diagnosis, therapy, and research. Sleep disorder clinics may provide some diagnostic or therapeutic services, which are covered under Medicare. These clinics may be affiliated either with a hospital or a freestanding facility. Whether a clinic…

General Documentation Guidelines for Teaching Physicians and Residents

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 contain a legible signature or identity and may be: • Dictated and transcribed;• Typed;• Hand-written; or• Computer-generated. A macro is a command in a computer or dictation application in an electronic medical record that automatically…

Exception for Evaluation and Management Services Furnished in Certain Primary Care Centers

Exception for Evaluation and Management Services Furnished in Certain Primary Care Centers

Medicare may grant a primary care exception within an approved GME Program in which you, the teaching physician, are paid for certain E/M services the resident performs when you are not present. The lower and mid-level E/M services included under the primary care exception are given below. New Patient CPT 99201    Office or other outpatient…

Evaluation and Management Documentation Guidelines for Teaching Physicians

Evaluation and Management Documentation Guidelines for Teaching Physicians

For a given encounter, the selection of the appropriate level of E/M services is determined according to the code of definitions in CPT books and any applicable documentation guidelines. CPT books are available from the American Medical Association. When a Teaching Physician bills for E/M services, he or she must personally document at least the…

Teaching physician – Billing requirements for surgeries and applicable modifiers

Teaching physician – Billing requirements for surgeries and applicable modifiers

The teaching surgeon is responsible for the preoperative, operative, and postoperative care of the beneficiary. The teaching physician’s presence is not required during the opening and closing of the surgical field unless these activities are considered to be critical or key portions of the procedure. The teaching surgeon determines which postoperative visits are considered key…

Learn about Rheumatoid arthritis

Learn about Rheumatoid arthritis

RHEUMATOID ARTHRITIS What is Rheumatoid Arthritis?What are the causes of Rheumatoid Arthritis?What are the signs and symptoms of RA?What are the Physiotherapy Treatment Modalities? Rheumatoid Arthritis Rheumatoid arthritis (RA) is a chronic and painful clinical condition that leads to progressive joint damage, disability and shortened life expectancy. Even a mild inflammation may result in irreversible…