Reimbursement for allergy testing is based on the number of each type of test performed by the same physician and is subject to the following… Read More »Allergy Test CPT Codes Limitation for Florida Blue
Novitas Solutions recently released a Modifier 50 Fact Sheet. It’s reminding to medical coders of the proper use for this CPT payment modifier. The Medicare… Read More »Proper Use of Modifier 50
The new Molecular Pathology changes will be effective from dates of service on and after Sept. 1, 2019. American Medical Association (AMA) guidance provides Claim… Read More »New Molecular Pathology guidelines in UHC effective Sept 1, 2019
Hernia repair (43280, 43281, 43332, 43334, 43336) is considered an incidental procedure when performed during the same operative session as bariatric surgery (43644, 43645, 43770,… Read More »Revised Bundling Guidelines for BCBS of North Carolina
Transcatheter Aortic Valve Replacement Transcatheter aortic valve replacement (TAVR – also known as TAVI or transcatheter aortic valve implantation) is a new technology for use… Read More »TAVR Approved Clinical Study
The major risk of allergen immunotherapy is anaphylaxis; in rare cases, this can be fatal despite optimal management. Because most serious systemic reactions occur within… Read More »Place of Service covered for Allergen Immunotherapy
Both “off-the-shelf” (OTS) and custom-fit items are considered prefabricated braces for Medicare coding purposes. 42 CFR §414.402 establishes that correct coding of Ankle-foot orthoses (AFO)… Read More »Coding guidelines for AFO & KAFO
Initial hospital visit following admission for a 42-year-old male for observation following an uncomplicated mandible fracture. (Plastic Surgery/Oral & Maxillofacial Surgery) Initial hospital visit for… Read More »Clinical Examples for 99221
Initial office visit for a 13-years-old female with progressive scoliosis. (Orthopaedic Surgery) Initial office visit for a 34-years-old female with primary infertility for evaluation and… Read More »Clinical Examples for 99204
Initial office consultation for a 60-year-old male with avascular necrosis of the left femoral head with increasing pain. (Orthopaedic Surgery) Office consultation for a 31-year-old… Read More »Clinical Examples for 99243