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10022 | Fna w/image | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. |
76536 | US THYROID | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. |
60100 | PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. - Diabetes education – this is covered by most insurance carriers, but the CPT code they accept for this type of service often varies. |
76942 | US GUID NEEDLE PLCMNTPORTABLE | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. - Diabetes education – this is covered by most insurance carriers, but the CPT code they accept for this type of service often varies. |
10022 | Fna w/image | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. - Diabetes education – this is covered by most insurance carriers, but the CPT code they accept for this type of service often varies. |
76536 | US THYROID | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
- CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
- CPT 10022 – fine needle aspiration; with image guidance
- CPT 60100 – biopsy thyroid, percutaneous core needle
Other Services Covered
- Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service. - Diabetes education – this is covered by most insurance carriers, but the CPT code they accept for this type of service often varies. |
S2140 | Cord blood harvesting for transplantation, allogeneic | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
38206 | PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
88240 | HC CRYOPRESERVATION | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
38205 | PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
38207 | PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
S2142 | Cord blood-derived stem-cell transplantation, allogeneic | HCPCS | There are rules and regulations for billing umbilical cord blood preservation. Medical billing company helps practices to report the perfect codes, clean billing, and reimburse appropriate payment for services provided. ICD-10, CPT and HCPCS codes for Umbilical Cord Blood Harvesting and Storage are:
Z52.001 - Unspecified donor, stem cells
Z52.011 - Autologous donor, stem cells
Z52.092 - Other blood donor, stem cells
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
38206 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
38207 - Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
88240- Cryopreservation, freezing and storage of cells, each cell line
S2140 - Cord blood harvesting for transplantation, allogeneic
S2142 - Cord blood-derived stem-cell transplantation, allogeneic |
E1340 | Repair for DME - per 15 min | CPT | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
A4556 | PT ELECTRODES | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
1999 | ANESTHESIOLOGY GROUP | CPT | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
E0608 | APNEA MONITOR | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
A4557 | Lead wires, pair | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
E0619 | Apnea monitor w recorder | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
E0618 | Apnea monitor, without recording feature | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. |
E1340 | Repair for DME - per 15 min | CPT | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
A4556 | PT ELECTRODES | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
1999 | ANESTHESIOLOGY GROUP | CPT | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
E0608 | APNEA MONITOR | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
A4557 | Lead wires, pair | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
E0619 | Apnea monitor w recorder | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
E0618 | Apnea monitor, without recording feature | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. |
E1340 | Repair for DME - per 15 min | CPT | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
A4556 | PT ELECTRODES | HCPCS | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
1999 | ANESTHESIOLOGY GROUP | CPT | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
E0608 | APNEA MONITOR | HCPCS | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
A4557 | Lead wires, pair | HCPCS | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
E0619 | Apnea monitor w recorder | HCPCS | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
E0618 | Apnea monitor, without recording feature | HCPCS | 6/1992: Pneumogram policy approved by Medical Policy Advisory Committee (MPAC)
8/1992: Home Apnea Monitor policy approved by Medical Policy Advisory Committee (MPAC)
9/1999: Policies merged; interim policy changes made
11/1999: Revisions to interim policy approved by MPAC
2/27/2002: Managed Care Requirements deleted
3/6/2002: Individual consideration requirement deleted
5/1/2002: Type of Service and Place of Service deleted
3/12/2003: Code Reference section updated
7/2003: Reviewed by MPAC, adapted American Academy of Pediatrics recommendations, HCPCS A4556, A4557completed description added, note E0608 deleted 2003
11/1/2004: Code Reference section updated, ICD-9 diagnosis code 768.2, 768.3, 768.5, 768.6, 768.9, 769, 770.0, 770.2, 770.4, 770.5, 770.6, 770.7, 779.81, 786.09 added, ICD-9 diagnosis 770.8 5th digit added, HCPCS E0608, E1340 deleted, HCPCS E0618, E0619 effective date of 1/1/2003 added
9/12/2006: Coding updated. ICD9 2006 revisions added to policy
10/18/2006: Policy reviewed, no changes
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions
7/17/2008: Policy statements revised, but materially remain unchanged. Removed the following policy statements: home apnea monitoring is considered medically necessary until 43 weeks postmenstrual age or after the cessation of extreme episodes, whichever comes last in infants less than 12 months of age, as documented by a letter from the prescribing physician; and physician certification of close supervision and continuous care plan requirement. Pneumogram information removed from policy. Removed performance of a pneumogram in the hospital and home setting is considered medically necessary for patients with documented clinically significant apnea. |
00100 | ANESTH SALIVARY GLAND | CPT | What is the Difference Between Medical Insurance Coding and Medical Billing? A medical coder's job is to assign the proper codes to clinical statements. A medical coder will use a five-digit code known as Current Procedural Terminology (CPT®) to report all known types of medical services and procedures that includes nearly 10,000 unique codes. The Current Procedural Terminology codes is copyrighted by the AMA (American Medical Association) and was first published in 1966. The CPT® codes fall into three primary categories:
Category I is a five-digit code with descriptors corresponding to a specific service or procedures, ranging from 00100 – 99499. |
00100 | ANESTH SALIVARY GLAND | CPT | A medical coder will use a five-digit code known as Current Procedural Terminology (CPT®) to report all known types of medical services and procedures that includes nearly 10,000 unique codes. The Current Procedural Terminology codes is copyrighted by the AMA (American Medical Association) and was first published in 1966. The CPT® codes fall into three primary categories:
Category I is a five-digit code with descriptors corresponding to a specific service or procedures, ranging from 00100 – 99499. Category II is an alphanumeric code used for execution measurement. Category III is designated for provisional codes for new and/or emerging services and technology. |
0853 | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment | RC | You may turn in the CASE STUDY early (no earlier than October 25 th ). It will be due
GAIN and DSM GAIN National Clinical Training Team 2011 Version 2 Materials Presentation Objectives Understand which DSM diagnoses are generated by GAIN ABS for the GAIN reports and which ones must be added
Guidelines for Understanding and Serving People with Intellectual Disabilities and Mental, Emotional, and Behavioral Disorders Contract Number 732HC08B Prepared by Human Systems and Outcomes, Inc. Edited
Serious Mental Illness (SMI) SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the diagnoses. Adults must meet all of the following five criteria:
Mental Health ICD-10 Codes Department of Health and Mental Hygiene (2) For dates of service on or after October 1, 2015: F200 F201 F202 F203 F205 F2081 F2089 F209 F21 F22 F23 F24 F250 F251 F258 F259 F28
Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9
Mr. Pustay AP PSYCHOLOGY AP PSYCHOLOGY CASE STUDY OVERVIEW: We will do only one RESEARCH activity this academic year. You may turn in the CASE STUDY early (no earlier than MID-TERM date). It will be due
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault [email protected] Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Page 1 of 5 Mental Illness and Intellectual Disability A review of Diagnostic Manual Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability by Robert
Understanding Mental Health Conditions Mental health conditions can affect anyone, including people with developmental disabilities. |
0853 | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment | RC | Adults must meet all of the following five criteria:
Mental Health ICD-10 Codes Department of Health and Mental Hygiene (2) For dates of service on or after October 1, 2015: F200 F201 F202 F203 F205 F2081 F2089 F209 F21 F22 F23 F24 F250 F251 F258 F259 F28
Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9
Mr. Pustay AP PSYCHOLOGY AP PSYCHOLOGY CASE STUDY OVERVIEW: We will do only one RESEARCH activity this academic year. You may turn in the CASE STUDY early (no earlier than MID-TERM date). It will be due
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault [email protected] Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Page 1 of 5 Mental Illness and Intellectual Disability A review of Diagnostic Manual Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability by Robert
Understanding Mental Health Conditions Mental health conditions can affect anyone, including people with developmental disabilities. In fact, there is a special term used to describe having both a diagnosis
INFORMATION SHEET Age Group: Sheet Title: Adults Depression or Mental Health Problems People with Asperger s Syndrome are particularly vulnerable to mental health problems such as anxiety and depression,
Covered Diagnoses & Crosswalk of DSM-IV Codes to ICD-9-CM Codes What is the crosswalk? The crosswalk is a document designed to help you determine which ICD-9-CM diagnosis code corresponds to a particular
Personality Disorders (PD) Summary (print version) 1/ Definition A Personality Disorder is an abnormal, extreme and persistent variation from the normal (statistical) range of one or more personality attributes
Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual
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Addictions and Mental Health Division Programs Central Intake Referral Form The Central Intake Referral Form is used in the District of Nipissing by the North Bay Regional Health Centre s Addictions and
Florida Medicaid: Mental Health and Substance Abuse Services Beth Kidder Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration House Children, Families, and Seniors Subcommittee
Abnormal Psychology PSY-350-TE This TECEP tests the material usually taught in a one-semester course in abnormal psychology. |
0622 | Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services | RC | There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. |
0305 | Thrombin time, fibrinogen screening test, plasma | RC | There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. |
0145 | Med-Surg | RC | There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. |
0622 | Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services | RC | In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. |
0305 | Thrombin time, fibrinogen screening test, plasma | RC | In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. |
0145 | Med-Surg | RC | In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. |
0622 | Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services | RC | We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1. |
0305 | Thrombin time, fibrinogen screening test, plasma | RC | We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1. |
0145 | Med-Surg | RC | We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1. |
36415 | VENIPUNCTURE | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
99202 | PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
V5060 | HB HEARING AID REPLACEMENT | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
D5110 | PR COMPLETE DENTURE - MAXILLARY | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
E0110 | Crutch forearm pair | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
86774 | HC TETANUS ANTIBODY | HCPCS | This is a disservice to the patient who deserves to understand what they are being billed for, and can make a person feel intimidated and disempowered. Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? |
36415 | VENIPUNCTURE | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
99202 | PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
V5060 | HB HEARING AID REPLACEMENT | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
D5110 | PR COMPLETE DENTURE - MAXILLARY | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
E0110 | Crutch forearm pair | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
86774 | HC TETANUS ANTIBODY | HCPCS | Are you in need of medical billing help? Call us today at 888.767.1077 or fill out our contact form and we’ll contact you ASAP! Three Different Medical Coding Systems With Examples:
- CPT codes were developed by The American Medical Association (AMA) and are used by physicians and hospitals to describe services, such as:
- 99202 – Office visit for new patient, under 20 minutes
- 36415 – Drawing blood
- 86774 – Tetanus shot
- Level II HCPCS codes are used by Medicare to describe equipment and services that the CPT codes don’t include, such as:
- V5060 – Hearing aid
- D5110 – Dentures
- E0110 – Crutches
- ICD-9 and -10 codes consist of diagnosis codes that are used in conjunction with CPT codes by The World Health Organization, such as:
- 650.0 – Normal childbirth delivery
- 301.0 – Paranoid personality
- 783.0 – Anorexia
Benefits Of A Medical Coding Career:
- A flexible schedule, able to work from home, low overhead
- Short training time with online classes
- High demand job with many opportunities
- Health care field without the usual physical demands
- Great pay
Medical Coding Benchmarks
Efficiency and accuracy are the ultimate goals of any medical coding professional and there are various degrees or levels of proficiency. How to establish productivity standards and improve on them? Although medical insurance coders go thru a rigorous training to earn a professional certificate, once out in the field, a medical coder’s efficiency varies widely. |
1610 | Anesthesia for Nerves, Muscles, Tendons, etc. Shoulder | HCPCS | American Medical Association: Find AMA / CPT codes. Centers For Medicare & Medicaid Services: Find HCPCS codes. Centers For Disease Control And Prevention: Find ICD-9 and ICD-10 codes. Are you in need of medical coding assistance? Call us today at 866.254.1610 or fill out our contact form and we’ll contact you ASAP! |
00216 | ANESTH HEAD VESSEL SURGERY | CPT | For this procedure, we’d code 35471 for “transluminal balloon angioplasty, percutaneous; renal or other visceral artery,” and we’d add the modifier -66 for “surgical team.” So we’d end up with 35471-66. Source: http://www.medicalbillingandcoding.org/cpt-modifiers/
Physical Status Modifier (For Anesthesia)
Anesthesia procedures have their own special set of modifiers, which are simple and correspond to the condition of the patient as the anesthesia is administered. These codes are:
- P1 – a normal, healthy patient
- P2 – a patient with mild systemic disease
- P3 – a patient with severe systemic disease
- P4 – a patient with severe systemic disease that is a constant threat to life
- P5 – a moribund patient who is not expected to survive without the operation
- P6 – a declared brain-dead patient whose organs are being removed for donor purposes
These are relatively straightforward, but let’s look at an example that will also use some of the CPT modifiers we learned just a minute ago. Let’s return to that angioplasty example. The patient needs to be anesthetized before undergoing this procedure, so we turn to the Anesthesia section of the CPT codebook and find the code 00216 for “vascular procedures.” Now, kidney problems notwithstanding, our patient is in good health, so we’d add the –P1 modifier to this anesthesia code, and end up with 00216-P1. |
00216 | ANESTH HEAD VESSEL SURGERY | CPT | These codes are:
- P1 – a normal, healthy patient
- P2 – a patient with mild systemic disease
- P3 – a patient with severe systemic disease
- P4 – a patient with severe systemic disease that is a constant threat to life
- P5 – a moribund patient who is not expected to survive without the operation
- P6 – a declared brain-dead patient whose organs are being removed for donor purposes
These are relatively straightforward, but let’s look at an example that will also use some of the CPT modifiers we learned just a minute ago. Let’s return to that angioplasty example. The patient needs to be anesthetized before undergoing this procedure, so we turn to the Anesthesia section of the CPT codebook and find the code 00216 for “vascular procedures.” Now, kidney problems notwithstanding, our patient is in good health, so we’d add the –P1 modifier to this anesthesia code, and end up with 00216-P1. Source: http://www.medicalbillingandcoding.org/cpt-modifiers/
Complete List of CPT Modifiers 2015
To view a complete list of CPT Modifiers, you can check out these resources below:
- 2014 Level I and Level II CPT Modifiers
- CPT and HCPCS Level II Modifiers
- 2012 Coding Modifiers Table
As the year comes to an end and a new one is upon us, Certification Coaching Organization (CCO) has finally launched a video that explains exactly what is changing in CPT 2015. And we've done it in a “warm and fuzzy” fashion — The CCO Webinar on CPT Modifiers 2015 Updates. |
00216 | ANESTH HEAD VESSEL SURGERY | CPT | Let’s return to that angioplasty example. The patient needs to be anesthetized before undergoing this procedure, so we turn to the Anesthesia section of the CPT codebook and find the code 00216 for “vascular procedures.” Now, kidney problems notwithstanding, our patient is in good health, so we’d add the –P1 modifier to this anesthesia code, and end up with 00216-P1. Source: http://www.medicalbillingandcoding.org/cpt-modifiers/
Complete List of CPT Modifiers 2015
To view a complete list of CPT Modifiers, you can check out these resources below:
- 2014 Level I and Level II CPT Modifiers
- CPT and HCPCS Level II Modifiers
- 2012 Coding Modifiers Table
As the year comes to an end and a new one is upon us, Certification Coaching Organization (CCO) has finally launched a video that explains exactly what is changing in CPT 2015. And we've done it in a “warm and fuzzy” fashion — The CCO Webinar on CPT Modifiers 2015 Updates. In this webinar, you will learn about the 143 deleted codes and why they were given the boot. |
00216 | ANESTH HEAD VESSEL SURGERY | CPT | The patient needs to be anesthetized before undergoing this procedure, so we turn to the Anesthesia section of the CPT codebook and find the code 00216 for “vascular procedures.” Now, kidney problems notwithstanding, our patient is in good health, so we’d add the –P1 modifier to this anesthesia code, and end up with 00216-P1. Source: http://www.medicalbillingandcoding.org/cpt-modifiers/
Complete List of CPT Modifiers 2015
To view a complete list of CPT Modifiers, you can check out these resources below:
- 2014 Level I and Level II CPT Modifiers
- CPT and HCPCS Level II Modifiers
- 2012 Coding Modifiers Table
As the year comes to an end and a new one is upon us, Certification Coaching Organization (CCO) has finally launched a video that explains exactly what is changing in CPT 2015. And we've done it in a “warm and fuzzy” fashion — The CCO Webinar on CPT Modifiers 2015 Updates. In this webinar, you will learn about the 143 deleted codes and why they were given the boot. You will also learn the 264 New codes and when to use them and if they replaced older codes and more. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | With appropriate training from an accredited education program, professional medical billers and certified medical coders navigate these issues every day as part of their workday routine. It is a rewarding career, and it is an essential part of the healthcare industry. Medical billing and medical coding are based on the Healthcare Common Procedural Coding System (HCPCS), the foundation of how medical claims are submitted to commercial health insurers and government healthcare programs. The Healthcare Portability and Protection Act of 1996 (HIPPA) mandated that all healthcare claims be reported using HCPCS. Medical billers ensure that all healthcare claims are compliant with HIPPA through the accurate application of medical codes based on the documentation in the patient’s medical record, and based on the standards established by HCPCS. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | It is a rewarding career, and it is an essential part of the healthcare industry. Medical billing and medical coding are based on the Healthcare Common Procedural Coding System (HCPCS), the foundation of how medical claims are submitted to commercial health insurers and government healthcare programs. The Healthcare Portability and Protection Act of 1996 (HIPPA) mandated that all healthcare claims be reported using HCPCS. Medical billers ensure that all healthcare claims are compliant with HIPPA through the accurate application of medical codes based on the documentation in the patient’s medical record, and based on the standards established by HCPCS. How HCPCS Codes are Used
The federal Centers for Medicare and Medicaid Services (CMS) oversees the definition and use of HCPCS codes. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | Medical billing and medical coding are based on the Healthcare Common Procedural Coding System (HCPCS), the foundation of how medical claims are submitted to commercial health insurers and government healthcare programs. The Healthcare Portability and Protection Act of 1996 (HIPPA) mandated that all healthcare claims be reported using HCPCS. Medical billers ensure that all healthcare claims are compliant with HIPPA through the accurate application of medical codes based on the documentation in the patient’s medical record, and based on the standards established by HCPCS. How HCPCS Codes are Used
The federal Centers for Medicare and Medicaid Services (CMS) oversees the definition and use of HCPCS codes. HCPCS are divided in two levels. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | The Healthcare Portability and Protection Act of 1996 (HIPPA) mandated that all healthcare claims be reported using HCPCS. Medical billers ensure that all healthcare claims are compliant with HIPPA through the accurate application of medical codes based on the documentation in the patient’s medical record, and based on the standards established by HCPCS. How HCPCS Codes are Used
The federal Centers for Medicare and Medicaid Services (CMS) oversees the definition and use of HCPCS codes. HCPCS are divided in two levels. Level I codes are commonly referred to as CPT codes because they belong to the Current Procedural Terminology (CPT) administered by the American Medical Association (AMA). |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | NCCI was established to prevent fraud and abuse of the Medicare system by preventing improper payments for services. Medical billers with the proper training understand that HCPCS Level I codes are used to bill Medicare, a government health insurance program that covers 48 million Americans, who make up a large percentage of any healthcare facility’s patient population. Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | Medical billers with the proper training understand that HCPCS Level I codes are used to bill Medicare, a government health insurance program that covers 48 million Americans, who make up a large percentage of any healthcare facility’s patient population. Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | Understanding the use of HCPCS Level I codes is essential for professional medical billers to obtain maximum, legal reimbursement for their employers. CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | CMS reviews the guidelines the AMA uses to define CPT codes, then it establishes coding methodologies and policies that promote correct coding on a national scale. Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare. While the guidelines are updated quarterly, a basic understanding of the use of HCPCS, and how they are meant to be used according to the NCCI, is essential to adapt to the ongoing changes in the healthcare industry. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | Because of the number of healthcare claims processed and paid by the Medicare Part B program, NCCI policies have been in place since 1996 to ensure that only appropriate claims are paid. The system has been expanded to include claims submitted under the Outpatient Prospective Payment System (OPPS) and claims submitted by skilled nursing facilities (SNFs). HCPCS Codes and NCCI
Medical billers and medical coders need to be aware of the current guidance established by the NCCI when they submit claims to Medicare. While the guidelines are updated quarterly, a basic understanding of the use of HCPCS, and how they are meant to be used according to the NCCI, is essential to adapt to the ongoing changes in the healthcare industry. Employers can be assured that professional medical billers and certified medical coders have this understanding after they have successfully completed a formal program of study offered by an accredited institution that teaches medical billing and medical coding. |
1999 | ANESTHESIOLOGY GROUP | CPT | The primary reason for medical coding is to ensure consistent classification and billing, as it enables physicians, medical centers, and third-party payers to “talk” in the same language. So where do these codes come from? There are four major “code sets” in the medical coding world, each with a different use:
- International Statistical Classification of Diseases and Related Health Problems (ICD), maintained by the World Health Organization
- International Statistical Classification of Diseases and Related Health Problems, Clinical Modification (ICD-CM), maintained by the Centers for Medicare and Medicaid Services and the National Center for Health Statistics
- Healthcare Common Procedure Coding System (HCPCS), maintained by the Centers for Medicare and Medicaid Services
- Current Procedural Terminology (CPT), maintained by the American Medical Association
Here’s how they fit together:
ICD-9: The ninth revision of the ICD code set, ICD-9 was used to classify mortality (death) in the U.S. until Jan. 1, 1999, and is now obsolete (replaced by ICD-10). ICD-9-CM: The ninth revision of the ICD code set with “clinical modifications,” ICD-9-CM is used today in the U.S. to classify morbidity (diagnoses/diseases) and inpatient medical procedures. It consists of three volumes: volume one (tabular listing of diagnosis codes), volume two (index of diagnosis codes), and volume three (procedure codes). |
1999 | ANESTHESIOLOGY GROUP | CPT | So where do these codes come from? There are four major “code sets” in the medical coding world, each with a different use:
- International Statistical Classification of Diseases and Related Health Problems (ICD), maintained by the World Health Organization
- International Statistical Classification of Diseases and Related Health Problems, Clinical Modification (ICD-CM), maintained by the Centers for Medicare and Medicaid Services and the National Center for Health Statistics
- Healthcare Common Procedure Coding System (HCPCS), maintained by the Centers for Medicare and Medicaid Services
- Current Procedural Terminology (CPT), maintained by the American Medical Association
Here’s how they fit together:
ICD-9: The ninth revision of the ICD code set, ICD-9 was used to classify mortality (death) in the U.S. until Jan. 1, 1999, and is now obsolete (replaced by ICD-10). ICD-9-CM: The ninth revision of the ICD code set with “clinical modifications,” ICD-9-CM is used today in the U.S. to classify morbidity (diagnoses/diseases) and inpatient medical procedures. It consists of three volumes: volume one (tabular listing of diagnosis codes), volume two (index of diagnosis codes), and volume three (procedure codes). An ICD-9-CM code has between three and five characters, such as 560, 553.3, or 560.81. |
39520 | Repair of diaphragm hernia | HCPCS | When you hear rumblings that medical centers are anxious about planned ICD changes, it’s this forthcoming implementation of ICD-10-CM across the U.S. that’s causing the angst. HCPCS: A two-level code set used to classify outpatient medical procedures. Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. |
00756 | Anesth repair of hernia | CPT | When you hear rumblings that medical centers are anxious about planned ICD changes, it’s this forthcoming implementation of ICD-10-CM across the U.S. that’s causing the angst. HCPCS: A two-level code set used to classify outpatient medical procedures. Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. |
39520 | Repair of diaphragm hernia | HCPCS | HCPCS: A two-level code set used to classify outpatient medical procedures. Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. |
00756 | Anesth repair of hernia | CPT | HCPCS: A two-level code set used to classify outpatient medical procedures. Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. |
39520 | Repair of diaphragm hernia | HCPCS | Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. |
00756 | Anesth repair of hernia | CPT | Level one consists of CPT codes (see below), while level two classifies non-physician services and supplies, such as ambulance transportation and medical equipment. CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. |
39520 | Repair of diaphragm hernia | HCPCS | CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. For humans, sorting through various code sets and tens of thousands of individual medical codes, while at the same time ensuring compliance with payer regulations, is about as much fun as doing taxes by hand. |
00756 | Anesth repair of hernia | CPT | CPT: Serves as HCPCS level one and is used in the U.S. today to classify all outpatient medical and surgical procedures (ICD-9-CM volume three is used to classify inpatient procedures). A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. For humans, sorting through various code sets and tens of thousands of individual medical codes, while at the same time ensuring compliance with payer regulations, is about as much fun as doing taxes by hand. |
39520 | Repair of diaphragm hernia | HCPCS | A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. For humans, sorting through various code sets and tens of thousands of individual medical codes, while at the same time ensuring compliance with payer regulations, is about as much fun as doing taxes by hand. That’s why numerous technological solutions have surfaced to help medical centers more efficiently assign codes and ensure accuracy. |
00756 | Anesth repair of hernia | CPT | A CPT code has five digits, such as 39520 or 00756. A subset of CPT codes, called evaluation and management (E&M) codes, are used to classify non-surgical physician visits/consultations. Put another way, in the U.S. today …
- ICD-9-CM volumes one and two are used to classify morbidity
- ICD-9-CM volume three is used to classify inpatient hospital procedures
- ICD-10 is used to classify mortality
- HCPCS level one (CPT) is used to classify outpatient procedures
- HCPCS level two is used to classify medical equipment, supplies, and drugs
The intersection of medical coding and health care information technology — pmFAQtory’s field — is pretty clear-cut. For humans, sorting through various code sets and tens of thousands of individual medical codes, while at the same time ensuring compliance with payer regulations, is about as much fun as doing taxes by hand. That’s why numerous technological solutions have surfaced to help medical centers more efficiently assign codes and ensure accuracy. |
G0071 | PR COMM SVCS BY RHC/FQHC 5 MIN | HCPCS | This will give you the experience that you need to land a better job in the Medical Coding field. See letter H if you are a current student of Coding Clarified. F – Federally Qualified Health Center (FQHC) – A Federally Qualified Health Center is an organization that provides a wide range of medical care services for the less fortunate community. Services may include primary care, dental care, mental health services, etc. These claims should be coded using HCPCS code G0071 alone or along with other G codes. |
G0071 | PR COMM SVCS BY RHC/FQHC 5 MIN | HCPCS | F – Federally Qualified Health Center (FQHC) – A Federally Qualified Health Center is an organization that provides a wide range of medical care services for the less fortunate community. Services may include primary care, dental care, mental health services, etc. These claims should be coded using HCPCS code G0071 alone or along with other G codes. G – GHP – Group Health Plan – A means for one or more employers to provide health benefits or medical care to their employees. H – HCC Internship- Hierarchical Conditional Category Medical Coding is a way for medical practices and hospitals to estimate a patient’s future health care costs. |
Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | HCPCS | Completing the Practicode speeds up the process of dropping the apprentice title from CPC-A to a CPC. Learn more. Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. |
Q0035 | PR CARDIOKYMOGRAPHY | HCPCS | Completing the Practicode speeds up the process of dropping the apprentice title from CPC-A to a CPC. Learn more. Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. |
Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | HCPCS | Learn more. Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. Understanding these will help you to ensure that you have chosen the correct codes and assist in accuracy. |
Q0035 | PR CARDIOKYMOGRAPHY | HCPCS | Learn more. Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. Understanding these will help you to ensure that you have chosen the correct codes and assist in accuracy. |
Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | HCPCS | Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. Understanding these will help you to ensure that you have chosen the correct codes and assist in accuracy. S – Scholarships – Coding Clarified is proud to be partnered with a plethora of Workforces in many states to offer you scholarships. |
Q0035 | PR CARDIOKYMOGRAPHY | HCPCS | Q – Q codes – are temporary codes that the Centers for Medicare & Medicaid Services (CMS) establishes to represent services and supplies that do not yet have a permanent code. These codes are part of the HCPCS Codes from Q0035-Q9992. R – Relative Value Unit (RVU) – These units define the value of a procedure or service. Understanding these will help you to ensure that you have chosen the correct codes and assist in accuracy. S – Scholarships – Coding Clarified is proud to be partnered with a plethora of Workforces in many states to offer you scholarships. |
82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
33871 | Transvrs a-arch grf hypthrm | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
80061 | TTH LIPID-SP | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
G0446 | PR INTENS BEHAVE THER CARDIO DX | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
83718 | LIPOPROTEIN, DIRECT MEASUREMENT_ HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. |
82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. To see CRs specific to individual ICD-10 codes for IBT for CVD, go to the CMS Medicare Coverage – General Information ICD-10 webpage. |
80061 | TTH LIPID-SP | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. To see CRs specific to individual ICD-10 codes for IBT for CVD, go to the CMS Medicare Coverage – General Information ICD-10 webpage. |
83718 | LIPOPROTEIN, DIRECT MEASUREMENT_ HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare patient and don’t have apparent signs or symptoms of CVD, you are still covered once every five years for cardiovascular disease screening tests. These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, other codes may apply, as well. To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent and alert at the time counseling is provided” and if the counseling is furnished “by a qualified primary care physician or other primary care practitioner in a primary care setting.” Coding for the CVD risk reduction visit includes HCPCS Level II G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes. To see CRs specific to individual ICD-10 codes for IBT for CVD, go to the CMS Medicare Coverage – General Information ICD-10 webpage. |
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