1995 vs 1997 E&M Guidelines

1995 vs 1997 E&M Guidelines

There are two versions of the documentation guidelines – the 1995 version and the 1997 version. The most substantial difference between 95 and 97 guidelines occur in the examination documentation section. Either version of the documentation guidelines, not a combination of the two, may be used by the provider for a patient encounter. 1995 E/M…

(2022) How To Bill Oxygen Use (CPT E0424, CPT E0441 & CPT E0443)

(2022) How To Bill Oxygen Use (CPT E0424, CPT E0441 & CPT E0443)

Below are the oxygen administration codes CPT E0424, CPT E0441 & CPT E0443 and modifiers for oxygen use. CPT Codes For Oxygen CPT E0424 Description of CPT E0424: Stationary Compressed Gaseous Oxygen System, Rental; Includes Container, Contents, Regulator, Flowmeter, Humidifier, Nebulizer, Cannula or Mask, and Tubing. CPT E0441 Description of CPT E0441: Stationary Oxygen Contents,…

(2022) Pulmonary Function Test CPT Codes (PFT CPT Codes)

(2022) Pulmonary Function Test CPT Codes (PFT CPT Codes)

Recovery Auditors have identified overpayments associated with Evaluation and Management (E/M) Services (CPT for Pulmonary Diagnostic Procedures). These overpayments occurred due to claims billed without Modifier 25 on the same date of service as a pulmonary diagnostic, therapeutic, or monitoring procedure.  Use of modifier 25, when providing pulmonary diagnostic, therapeutic, or monitoring procedures. CPT Codes…

Revised NCD list

Revised NCD list

This Change Request (CR) constitutes a maintenance update of ICD-10 conversions and other coding updates specific to NCDs effective from January 2020 These NCD codes changes are the results of newly available code sets and coding revisions to NCDs released separately. The revised NCD codes lists are, NCD110.18 Aprepitant: Contractors shall add J9036 as covered effective July…

Medicare deductible, coinsurance, and premium rates

Medicare deductible, coinsurance, and premium rates

The Centers for Medicare & Medicaid Services (CMS) issued the 2016 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. The 2016 deductible, coinsurance and base premium rates are: 2016 PART A – HOSPITAL INSURANCE (HI Deductible:$1,288.00 Coinsurance: $322.00 a day for 61st-90th day $644.00 a day for 91st-150th…

Providers & Suppliers To Comply With MAC Request For Fingerprints

Providers & Suppliers To Comply With MAC Request For Fingerprints

CMS implemented the fingerprint-based background requirement on August 6, 2014, as discussed in the rule published on February 2, 2011. Fingerprint-based background checks are required for all individuals with a 5 percent or greater ownership interest in a provider or supplier that falls into the high risk category and is currently enrolled in Medicare or…