Medicaid of Georgia Reimbursement for Fluoride Varnish

Medicaid of Georgia Reimbursement for Fluoride Varnish

Patients at risk for caries include those with: insufficient sources of dietary fluoride; high carbohydrate diets; caretakers who transmit decay-causing bacteria to children via their saliva; areas of tooth decalcification; reduced salivary flow; and poor oral hygiene. Fluoride varnish acts to retard, arrest, and reverse the caries process. The teeth absorb the fluoride varnish, strengthening the enamel and…

Medicaid Schedule for CHILD HEALTH CHECK-UP

Medicaid Schedule for CHILD HEALTH CHECK-UP

Child Health Check-Up (formerly known as Early and Periodic Screening, Diagnosis and Treatment [EPSDT] services) consists of a comprehensive, preventive health screening that is performed on a periodic basis on children under the age of 21. A Child Health Check-Up includes a comprehensive: (1) Health and developmental history; an assessment of past medical history, developmental history and behavioral health status;…

Medicaid Reimbursement for Physician Services

Medicaid reimburses for services rendered by licensed, Medicaid-participating doctors of medicine or osteopathic medicine. The services can be rendered in the physician’s office, the patient’s home, a hospital, a nursing facility or other approved places of services as necessary to treat a particular injury, illness, or disease. LIMITATIONS: Medicaid reimbursement for physician services is limited to: •…

Medicaid reimbursement for Children’s Dental Services

Medicaid reimburses for children’s dental services rendered by licensed, Medicaid participating dentists. Medicaid reimbursable children’s dental services include: •  Diagnostic examinations •  Radiographs necessary to make a diagnosis •  Preventive services •  Restorations •  Endodontics •  Periodontal treatment •  Dentures, complete and partial •  Oral surgery •  Orthodontic treatment LIMITATIONS: Medicaid does not reimburse for…

Extension of Enforcement Discretion Period for Updated HIPAA Standards

Extension of Enforcement Discretion Period for Updated HIPAA Standards

On March 15, 2012, CMS’ Office of E-Health Standards and Services (OESS) announced that it will not initiate enforcement action for an additional three months, through June 30, 2012, against any covered entity that is required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)…

Aetna Non-covered Lab code list

Aetna Non-covered Lab code list

Aetna plans do not cover laboratory tests that are considered experimental or investigational, even when these studies are ordered by a participating physician. The below listed code are some of the most commonly ordered experimental or investigational lab tests. Homocysteine cardiovascular test (CPT 83090) Lipoprotein (A) (CPT 83695) Immunoassay for tumor antigen, quantitative CA 19-9…

Medicaid Reimbursement for Chiropractic Services

Medicaid Reimbursement for Chiropractic Services

Medicaid reimburses for services rendered by licensed, Medicaid-participating chiropractors. Medicaid reimbursable services include a new patient visit, manipulation of the spine, and spinal x-rays. The new patient visit consists of a screening and any required manipulation of the spine. LIMITATIONS: Medicaid reimbursement for chiropractic services is limited to one visit per provider, per recipient, per…

Hospice Care

Hospice Care

Hospice is a program of care and support for people who are terminally ill. Here are some important facts about hospice: Hospice helps people who are terminally ill live comfortably. The focus is on comfort, not on curing an illness. A specially trained team of professionals and caregivers provide care for the “whole person,” including…

CPT Code 99291 & CPT Code 99292 Reimbursement

CPT Code 99291 & CPT Code 99292 Reimbursement

Critical care is the care and monitoring of unstable critically ill or injured patients in a variety of medical emergencies that require constant attention that can only be provided by a physician. The care of such patients involves decision-making of such high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like conditions, renal, hepatic,…