CPT G0444 (2021)

CPT G0444 (2021)

Reimbursement Guidelines for Depression Screening – CPT G0444 Depression screening CPT G0444 can’t be coded with CPT G0402 & G0438 but you may report with CPT G0439. NCCI edits stated as “Code G0444 is a column 2 code for G0402. You may not override the edit”.Nationally Covered Indications: CMS will cover annual screening up to 15…

Per Mile Travel Allowance P9603

Per Mile Travel Allowance P9603

In addition to a specimen collection fee Medicare, under Part B, covers a  travel allowance for a laboratory technician to draw a specimen from either a nursing home patient or homebound patient. The travel allowance is intended to cover the estimated travel costs of collecting a specimen and to reflect the technician’s salary and travel costs….

CMS NEWS: Medicare will now cover lung cancer screening with Low Dose Computed Tomography (LDCT)

CMS NEWS: Medicare will now cover lung cancer screening with Low Dose Computed Tomography (LDCT)

National Coverage Determination (NCD) for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT)Today the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination that provides for Medicare coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT). The coverage is effective immediately. “This is the first time…

Will Medicare contractors accept the CPT consultation codes when Medicare is the secondary payer?

Will Medicare contractors accept the CPT consultation codes when Medicare is the secondary payer?

Medicare will also no longer recognize the CPT consultation codes for purposes of determining Medicare secondary payments (MSP). In MSP cases, providers must bill an appropriate E/M code for the E/M services previously reported and paid using the CPT consultation codes. If the primary payer for the service continues to recognize CPT consultation codes for…

Power Mobility Device (PMD) Prior Authorization Demonstration Project

Power Mobility Device (PMD) Prior Authorization Demonstration Project

The Centers for Medicare & Medicaid Services (CMS), in its effort to reduce waste, fraud, and abuse in the Medicare fee-for-service program, is conducting a three-year demonstration to ensure that Medicare only pays for power mobility devices (PMDs) that are medically necessary. This demonstration began with orders written on or after September 1, 2012. The demonstration will…

Pulmonary Procedures and Evaluation & Management (E/M) Services performed on the same day

Pulmonary Procedures and Evaluation & Management (E/M) Services performed on the same day

Recovery Auditors have identified overpayments associated with Evaluation and Management (E/M) Services (Common Procedure Terminology (CPT) 99211-99213) 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 (94010-94799).  You and your staff should be familiar with the…

CPT codes for PAP Tests (2021)

CPT codes for PAP Tests (2021)

HCPCS Codes for Screening Pap Tests The following contains the PAP CPT Code: G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision G0143 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual…

List of Preventive Services Covered by Medicare

List of Preventive Services Covered by Medicare

The following Medicare-covered preventive services and screenings are subject to certain eligibility and other limitations: Abdominal Aortic Aneurysm Screening; Adult Immunizations; Annual Wellness Visit, Including Personalized Prevention Plan Services effective 1/1/11; Bone Mass Measurements; Cancer Screenings; Cardiovascular Screening; Diabetes Screening; Diabetes Self-Management Training; Diabetes Supplies; Glaucoma Screening; HIV Screening; Initial Preventive Physical Exam (“Welcome to…