MA Bulletin Keystone Mercy Health Plan is implementing the following changes:

Size: px
Start display at page:

Download "MA Bulletin 01-06-06 Keystone Mercy Health Plan is implementing the following changes:"

Transcription

1 September 1, 2006 Dear Keystone Mercy Provider: Effective July 17, 2006, the Pennsylvania Department of Public Welfare (DPW) has end-dated several local procedure codes pertaining to services offered in Medical Rehabilitation Units of General and Rehabilitation Hospitals. These local procedures codes were cross-walked to national procedure codes already listed on the Medical Assistance (MA) Program Fee Schedule. However, in some cases, the correlating national procedure code requires the addition of a modifier. modifiers should be placed in the 1 st modifier position, with informational modifiers placed in the subsequent position. Failure to use the appropriate national procedure code and modifier(s) combination will result in inappropriate claim payment or denial. Additionally, payment for the correlating national procedure code may be reimbursed at a higher or lower amount than its counterpart. As a result of the changes outlined by DPW in MA Bulletin Keystone Mercy Health Plan is implementing the following changes: If your facility currently bills for services using any of the local codes appearing on Attachment A, you may continue to bill using the local procedure code for services rendered on or before September 30, When billing for services rendered on or after October 1, 2006, you will need to begin using the corresponding national procedure code along with any pricing or informational modifier as it appears on Attachment A. If you have any questions regarding this change in reimbursement, please contact your Provider Account Executive, or call Provider Services at (800) Thank you for your participation in our network and your commitment to Keystone Mercy Health Plan members. Sincerely, William C. Morsell Senior Vice President Provider Network Management Attachment 200 Stevens Drive Philadelphia, PA

2 to Procedure Cross Walk Definition Definition W0644 General medical exam, pre-admission assessment program T1015 U7 Clinic visit/encounter, all-inclusive W0663 Outpatient hospital physical therapy T1015 U8 GP Clinic visit/encounter, all-inclusive W0664 Outpatient hospital occupational T1015 U8 GO Clinic visit/encounter, all-inclusive W0665 Outpatient hospital speech therapy T1015 U8 GN Clinic visit/encounter, all-inclusive W0666 Outpatient hospital physical therapy T1015 U7 GP Clinic visit/encounter, all-inclusive W0667 Outpatient hospital occupational T1015 U7 GO Clinic visit/encounter, all-inclusive W0668 Outpatient hospital speech therapy T1015 U7 GN Clinic visit/encounter, all-inclusive W9049 Hospital outpatient clinic visit (enrollment approval required) T1015 U5 Clinic visit/encounter, all-inclusive W9051 Basic hospital outpatient clinic visit T1015 U4 Clinic visit/encounter, all-inclusive W9064 Medical school clinic visit (enrollment approval required) T1015 U5 Clinic visit/encounter, all-inclusive W9416 Peak expiratory flow rate (PERF) Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without W9591 W9592 W9593 Electromyography, including nerve conduction velocites, one extremity and related para-spinal area Electromyography, including nerve conduction velocites, two extremities and related para-spinal area Electromyography, including nerve conduction velocites, three extremities and related para-spinal area maximal voluntary ventilation Needle electromyography, one extremity with or without related paraspinal areas Needle electromyography, two extremities with or without related paraspinal areas Needle electromyography, three extremities with or without related paraspinal areas W9630 General medical examination T1015 U7 Clinic visit/encounter, all-inclusive 1

3 to Procedure Cross Walk W9633 Definition Comprehensive medical examination by general practitioner when requested by the Department to determine eligibility Definition T1015 U7 Clinic visit/encounter, all-inclusive Chemotherapy administration, intravenous; push technique Chemotherapy administration, intravenous; infusion technique, up to one hour Chemotherapy administration, intravenous; infusion technique, one to eight hours, each additional hour Chemotherapy administration, intravenous, infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump Chemotherapy administration, intraarterial; push technique Chemotherapy administration, intraarterial; infusion technique, up to one hour Chemotherapy administration, intraarterial; infusion technique, one to eight hours, each additional hour Chemotherapy administration, intraarterial; infusion technique, initiation of prolonged infusion (more than 8 hours) requiring the use of a portable or implantable pump W9715 Physical therapy, two or more modalities and/or two or more procedures; initial 30 minutes T1015 U7 GP Clinic visit/encounter, all-inclusive 2

4 Medical Rehabilitation Units of General Hospital Rehabilitation Hospitals to Procedure Cross Walk Definition Definition X1101 Debridement of Ulcer, foot; initial Debridement; skin, partial thickness X1101 Debridement of Ulcer, foot; initial Debridement; skin, full thickness X1101 Debridement of Ulcer, foot; initial Debridement; skin, subcutaneous tissue X1101 Debridement of Ulcer, foot; initial Debridement; skin, subcutaneous tissue and muscle X1101 Debridement of Ulcer, foot; initial X1102 Debridement of Ulcer, foot; subsequent X1102 Debridement of Ulcer, foot; subsequent X1166 X1166 X1167 X1167 Debridement of hypertrophic nails; initial, multiple Debridement of hypertrophic nails; initial, multiple Debridement of hypertrophic nails; subsequent, multiple Debridement of hypertrophic nails; subsequent, multiple X1172 Avulsion of nail, partial, one nail X1172 Avulsion of nail, partial, one nail X1175 Excision of nail and nail matrix; partial, one nail T1-T9, TA, F1- F9, FA T1-T9, TA, F1- F9, FA T1-T9, TA, F1- F9, FA Debridement; skin, subcutaneous tissue, muscle and bone Debridement of extensive eczematous or infected skin; up to 10% of body surface Debridement of extensive eczematous or infected skin; each additional 10% of the body surface Debridement of nail(s) by any method(s); one to five Debridement of nail(s) by any method(s); six or more Debridement of nail(s) by any method(s); one to five Debridement of nail(s) by any method(s); six or more Avulsion of nail plate, partial or complete, simple; single Avulsion of nail plate, partial or complete, simple; single; each additional nail plate Exclusion of nail or nail matrix, partial or complete, (e.g. ingrown or deformed nail) for permanent removal 3

5 to Procedure Cross Walk X1177 X1720 Definition Excision of nail and nail matrix; complete, one nail Plantar verruca or verrucae, removal by any method except excision, such as superficial cutting or paring, chemotherapy, etc; subsequent treatment T1-T9, TA, F1- F9, FA Definition Exclusion of nail or nail matrix, partial or complete, (e.g. ingrown or deformed nail) for permanent removal Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; first lesion X1720 Plantar verruca or verrucae, removal by any method except excision, such as superficial cutting or paring, chemotherapy, etc; subsequent treatment Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; second through 14 lesions, each (list separately in addition to code for first lesion) X1720 Plantar verruca or verrucae, removal by any method except excision, such as superficial cutting or paring, chemotherapy, etc; subsequent treatment Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions X3643 Y7030 Transfusion, blood or blood components; direct Radiology diagnostic, both mandible and temporomandibular joints, panoramic views Transfusion, blood or blood components Radiologic examination, temporomandibular joint, open and closed mouth; bilateral 4

6 to Procedure Cross Walk Y7100 Y7101 Y7200 Y7211 Definition Radiologic examination, chest, two views, posterantherior and lateral, routine service, asymptomatic patient Radiologic examination, chest, two views, frontal and lateral; three views Radiologic examination, spine; scoliosis study, complete, minimum of four views three three three three three three three Radiologic diagnostic, lumbal spine and pelvis; complete lumbal spine with anteroposterior views of pelvis Definition Radiologic examination, chest, two views, frontal and lateral Radiologic examination, chest, two views, frontal and lateral Radiologic examination, spine; scoliosis study, including supine and erect studies cervical; two or three views cervical; minimum of four views thoracic, three views thoracic, minimum of four views lumbosacral; two or three views lumbosacral; minimum of four views lumbosacral, bending views only, minimum of four views entire, survey study, anteroposterior and lateral Y7308 Radiologic examination, elbow, comprehensive, minimum of five views RT, LT 50 Radiologic examination, elbow, complete, minimum of three views Y7310 Radiologic examination, wrist; comprehensive, minimum of five views RT, LT 50 Radiologic examination, wrist, complete, minimum of three views Y7311 Y7311 Radiology diagnostic, hand and wrist; limited, fewer that three views Radiology diagnostic, hand and wrist; limited, fewer that three views RT, LT RT, LT 50 Radiologic examination, wrist; two views Radiologic examination, hand; two views 5

7 to Procedure Cross Walk Definition Definition Y7312 Radiology diagnostic, hand and wrist; complete, fewer that three views RT, LT 50 Radiologic examination, wrist; complete, minimum of three views Y7312 Y7322 Y7323 Y7324 Y7325 Y7360 Y7419 Y7600 Radiology diagnostic, hand and wrist; complete, fewer that three views Magnetic Resonance (e.g., Proton) Imaging, upper extremity, other that joint with contrast material Magnetic Resonance Imaging, upper extremity, other that joint, without contrast materials, followed by contrast material Magnetic Resonance (e.g., Proton) Imaging, any joint of upper extremity; with contrast material Magnetic resonance imaging, any joint of upper extremity without contrast material, followed by contrast materials Radiologic examination, ankle; comprehensive, minimum of five views Magnetic resonance imaging, abdomen; without contrast material, followed by contrast material Extended room time with periodic fluoroscopy (radiological guidance), per 30 minutes RT, LT RT, LT RT, LT RT, LT RT, LT RT, LT Z0832 Pregnancy Test Radiologic examination, hand; complete, minimum of three views Magnetic resonance imaging, upper extremity, other that joint with contrast materials Magnetic resonance imaging, upper extremity, other that joint, without contrast materials and further sequencing Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; with contrast material(s) Magnetic resonance imaging, any joint of upper extremity without contrast material, followed by contrast material(s) and further sequences Radiologic examination, ankle, complete, minimum of 3 views Magnetic resonance imaging, abdomen; without contrast material, followed by contrast material(s) and further sequences Fluoroscopy, physician time more than one hour, assisting a nonradiologic physician (e.g., nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy) Urine pregnancy test, by visual color comparison methods 6

8 Medical Rehabilitation Units of General Hospital Rehabilitation Hospitals to Procedure Cross Walk Definition Z0832 Pregnancy Test Z0832 Pregnancy Test Z2100 Z2101 Z2102 Z2103 Z2105 Z2106 Alcohol (Ethanol), blood; quantitative (all methods) Alcohol(ethanol), urine; quantitative (all methods) Alcohol(ethanol), urine; quantitative (all methods) Drug screen (amphetamines, barbiturates, benzodiazepine, cocaine, methadone, methaqualone, opiates, phencyclidine (PCP), propoxyphene, THC (all methods) 1-5 Drug screen, fentanyl, fentanyl derivatives (all methods) Drug screen (amphetamines, barbiturates, benzodiazepine, cocaine, methadone, methaqualone, opiates, phencyclidine (PCP), propoxyphene, THC (all methods) U Definition Gonadotropin, chronic (hcg); quantitative Gonadotropin, chronic (hcg); qualitative Alcohol (ethanol); any specimen except breath Alcohol (ethanol); any specimen except breath Alcohol (ethanol); any specimen except breath Drug screen, qualitative; multiple drug classes chromatographic method, each procedure Drug screen, qualitative; single drug class method (e.g., immunoassay, enzyme assay), each drug class Antibody; HIV Antibody; HIV Drug screen, qualitative; multiple drug classes chromatographic method, each procedure Antibody; HTLV or HIV antibody, confirmatory test (e.g., Western Blot) Anti-body; HIV-1 and HIV-2, single assay

9 Z8227 Medical Rehabilitation Units of General Hospital Rehabilitation Hospitals to Procedure Cross Walk Definition Blood; occult feces, screening - asymptomatic patient Definition Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; HIV-1 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; HIV-2 Blood occult, by peroxidase activity (e.g., guaiac), qualitative; feces, 1-3 simultaneous determinations Z8294 Glucose; 2 hour postprandial Glucose; quantitative, blood (except reagent strip) Z8309 Haldol (Haloperidol) Haloperidol Z8374 Ludiomil (Maprotiline) Quantitation of drug, not elsewhere Z8391 Norpace (Disopryamide) Z8503 Z8503 Z8555 Z8555 Z8556 Blood count, hemogram, manual, completed CBC (RBC, WBC, Hgb, Hct, Differential and Indicies) - Asymptomatic patient Blood count, hemogram, manual, completed CBC (RBC, WBC, Hgb, Hct, Differential and Indicies) - Asymptomatic patient Blood cont; hematocrit - asymptomatic patient Blood cont; hematocrit - asymptomatic patient Blood count; Hematocrit and Hemoglobin (Hct and Hgb) specified Quantitation of drug, not elsewhere specified Blood count; hematocrit (Hct) Blood count; hematocrit (Hct)

10 Z8556 Z8557 Z8557 Definition Blood count; Hematocrit and Hemoglobin (Hct and Hgb) - asymptomatic patient Blood count; Hematocrit and Hemoglobin (Hct and Hgb) Blood count; Hematocrit and Hemoglobin (Hct and Hgb) Medical Rehabilitation Units of General Hospital Rehabilitation Hospitals to Procedure Cross Walk Z8604 Anti-Parietal AB Z8627 Z8627 Z8627 Z8631 Antibody; Epstein-Barr Virus (EBV), Complete Evaluation Antibody; Epstein-Barr Virus (EBV), Complete Evaluation Antibody; Epstein-Barr Virus (EBV), Complete Evaluation Immunoassay for Prostate Specific Antigen (PSA); Asymptomatic Patient Z8636 Mast Allergy Test; up to 5 antigens Z8637 Mast Allergy Test; 6 or more antigens Definition Fluorescent noninfectious agent antibody; screen, each antibody Antibody; Epstein-Barr (EB) virus, early antigen (EA) Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) Epstein-Barr (EB) virus, viral capsid (VCA) Prostate specific antigen (PSA); total Allergen specific IgE; quantitative or semiquantitative, each allergen Allergen specific IgE; quantitative or semiquantitative, each allergen Z8704 Campylobacter Culture, feces Antibody; campylobacter Z8708 Culture, screening for organism including sensitivity study, sources other than blood Z8708 Culture, screening for organism including sensitivity study, sources other than blood Culture, presumptive, pathogenic organisms, screening only Susceptibility studies, antimicrobial agent, agar, dilution method, per agent (e.g., antibiotic gradient strip) Z8708 Culture, screening for organism including sensitivity study, sources other than blood Susceptibility studies, antimicrobial agent, mycobacteria, proportion method, each agent 9

11 to Procedure Cross Walk Z8712 Definition Culture, urine; quantitative, with colony count including sensitivity study, screening Definition Culture, bacteria; quantitative colony count urine Z8712 Culture, urine; quantitative, with colony count including sensitivity study, screening Susceptibility studies, antimicrobial agent, agar, dilution method, per agent (e.g., antibiotic gradient strip) Z8712 Culture, urine; quantitative, with colony count including sensitivity study, screening Susceptibility studies, antimicrobial agent, mycobacteria, proportion method, each agent Z8713 Z8713 Culture urine; definitive and sensitivity study for specific microorganisms, with isolation of organism Culture urine; definitive and sensitivity study for specific microorganisms, with isolation of organism Culture, bacteria; quantitative colony count urine Culture, bacteria; with isolation and presumptive identification of isolates, urine 10

MA Bulletin 01-06-05, Keystone Mercy Health Plan is implementing the following changes:

MA Bulletin 01-06-05, Keystone Mercy Health Plan is implementing the following changes: September 1, 2006 Dear AmeriHealth Mercy Provider: Effective July 17, 2006, the Pennsylvania Department of Public Welfare (DPW) has end-dated several local procedure codes pertaining to services offered

More information

MODIFIER 59 ARTICLE. The CPT Manual defines modifier 59 as follows:

MODIFIER 59 ARTICLE. The CPT Manual defines modifier 59 as follows: MODIFIER 59 ARTICLE The Medicare National Correct Coding Initiative (NCCI) includes Procedure-to-Procedure (PTP) edits that define when two Healthcare Common Procedure Coding System (HCPCS)/ Current Procedural

More information

Kaiser Permanente 2015 Sample Fee List 1 Members in any deductible plan can use this list to help estimate their charges.

Kaiser Permanente 2015 Sample Fee List 1 Members in any deductible plan can use this list to help estimate their charges. Kaiser Permanente 2015 Sample Fee List 1 Members in any deductible plan can use this list to help estimate their charges. COLORADO As your partner in health, we want to help you manage your health care

More information

Case 2:10-md-02179-CJB-SS Document 6427-14 Filed 05/03/12 Page 1 of 5 EXHIBIT 12

Case 2:10-md-02179-CJB-SS Document 6427-14 Filed 05/03/12 Page 1 of 5 EXHIBIT 12 Case 2:10-md-02179-CJB-SS Document 6427-14 Filed 05/03/12 Page 1 of 5 EXHIBIT 12 Case 2:10-md-02179-CJB-SS Document 6427-14 Filed 05/03/12 Page 2 of 5 Components of the PERIODIC MEDICAL CONSULTATION PROGRAM

More information

10-144 Chapter 101 MAINECARE BENEFITS MANUAL CHAPTER III

10-144 Chapter 101 MAINECARE BENEFITS MANUAL CHAPTER III Last updated:. *Please note: As of the effective date of this rule, Family Planning agencies will be reimbursed at the same fee for service rates as other providers of these services, including Section

More information

2016 Mayo Clinic Health System Eau Claire Charge and Reimbursement Information for Health Care Consumers Required by 2009 Wisconsin Act 146

2016 Mayo Clinic Health System Eau Claire Charge and Reimbursement Information for Health Care Consumers Required by 2009 Wisconsin Act 146 2016 Mayo Clinic Health System Eau Claire Charge and Reimbursement Information for Health Care Consumers Required by 2009 Wisconsin Act 146 The Wisconsin Act 146 seeks to make cost and charge information

More information

Kaiser Permanente 2011 Sample Fee List Members in any deductible plan can use the sample fee list to estimate charges.

Kaiser Permanente 2011 Sample Fee List Members in any deductible plan can use the sample fee list to estimate charges. Kaiser Permanente 2011 Sample Fee List Members in any deductible plan can use the sample fee list to estimate charges. Colorado AREA As your partner in health, we want to help you better manage your care.

More information

Horizon Blue Cross Blue Shield of NJ Radiology Rules Bank

Horizon Blue Cross Blue Shield of NJ Radiology Rules Bank Horizon Blue Cross Blue Shield of NJ Radiology Rules Bank * Rule added 05/30/13 Code Pay Code Do Not Pay Source 70010 Myelography, posterior fossa, radiological supervision and 76000 Fluoroscopy, up to

More information

Coding and Billing for HIV Services in Healthcare Facilities

Coding and Billing for HIV Services in Healthcare Facilities P a g e 1 Coding and Billing for HIV Services in Healthcare Facilities The Hawai i State Department of Health STD/AIDS Prevention Branch is pleased to provide you information on billing and reimbursement

More information

Physicians as Assistants at Surgery: 2013 Study Participating Organizations:

Physicians as Assistants at Surgery: 2013 Study Participating Organizations: Physicians as Assistants at Surgery: 2013 Study Participating Organizations: American College of Surgeons American Academy of Ophthalmology American Academy of Orthopaedic Surgeons American Academy of

More information

Physicians as Assistants at Surgery: 2016 Update Participating Organizations:

Physicians as Assistants at Surgery: 2016 Update Participating Organizations: Physicians as Assistants at Surgery: 2016 Update Participating Organizations: American College of Surgeons American Academy of Ophthalmology American Academy of Orthopaedic Surgeons American Academy of

More information

Standing Authorizations Section

Standing Authorizations Section Standing Authorizations Section STANDING AUTHORIZATION... 3 DIAGNOSTIC TESTS... 3 Diagnostic Tests... 4 Diagnostic Tests... 5 Diagnostic Tests... 7 DME AND ORTHOTIC/PROSTHETIC DETAILS FOR NETWORK BLUE.

More information

Kaiser Permanente 2016 Sample Fees List 1

Kaiser Permanente 2016 Sample Fees List 1 Kaiser Permanente 2016 Sample Fees List 1 SOUTHERN CALIFORNIA Knowing how much you can expect to pay for care and services can give you peace of mind. This Sample Fees List shows you estimated fees for

More information

MHDO CompareMaine Updated: 9/17/2015

MHDO CompareMaine Updated: 9/17/2015 Office Visits -- Adult Preventative Care Office Visit (or Wellness Office Visit) 99385 New patient preventive care visit for adult, ages 18 to 39 99386 New patient preventive care visit for adult, ages

More information

Kaiser Permanente 2016 Sample Fee List *

Kaiser Permanente 2016 Sample Fee List * Kaiser Permanente 2016 Sample Fee List * NORTHWEST What s a Sample Fee List? Knowing how much you can expect to pay for care and services can help give you peace of mind. As a deductible plan member, you

More information

Guidance Document Infectious Substances

Guidance Document Infectious Substances Guidance Document Infectious Substances Note: 1. The following Guidance Document was developed by the ICAO DGP. The original ICAO document reflects references to the ICAO Technical Instructions these have

More information

PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION

PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION This booklet was designed to help you and the important people in your life understand the treatment of high dose chemotherapy with stem cell support: a procedure

More information

APPENDIX A GUIDANCE DOCUMENT

APPENDIX A GUIDANCE DOCUMENT APPENDIX A GUIDANCE DOCUMENT Infectious Substances International Civil Aviation Organization Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2005-2006 Note: This guidance document

More information

Hillsborough Community College - Ybor City Campus 1025C Laboratory Exercise 9: Testing Urine for the Presence of Drugs Introduction

Hillsborough Community College - Ybor City Campus 1025C Laboratory Exercise 9: Testing Urine for the Presence of Drugs Introduction Hillsborough Community College - Ybor City Campus 1025C Laboratory Exercise 9: Testing Urine for the Presence of Drugs Introduction Drug testing beyond the health care and criminal justice systems has

More information

If your doctor has ordered laboratory tests, it s natural

If your doctor has ordered laboratory tests, it s natural A Patient s Guide to Clinical oratory Testing at Kingman Regional Medical Center If your doctor has ordered laboratory tests, it s natural to have questions about why and how the tests are performed. This

More information

Anesthesia Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes

Anesthesia Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes Anesthesia Cross Coder Essential links from CPT codes to ICD-9-CM and HCPCS codes Contents Introduction... i CPT Anesthesia to Procedure Crosswalk...i Format...i Icon Key...ii CPT Codes...ii Code Links...iii

More information

INTRODUCTION: CPT CODES & ICD-9 CODES

INTRODUCTION: CPT CODES & ICD-9 CODES INTRODUCTION: CPT CODES & ICD-9 CODES Current Procedural Terminology (CPT) is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians.

More information

Section. 37Renal Dialysis Facility

Section. 37Renal Dialysis Facility Section 37Renal Dialysis Facility 37 37.1 Enrollment...................................................... 37-2 37.1.1 STAR and STAR+PLUS Program Enrollment.......................... 37-2 37.2 Reimbursement..................................................

More information

Medical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives

Medical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Program Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Student Learning Outcomes All Colorado Mesa University associate

More information

Coding guide for routine HIV testing in health care settings

Coding guide for routine HIV testing in health care settings Coding guide f routine HIV testing in health care settings Background In September of 2006, CDC issued recommendations f Human immunodeficiency virus (HIV) testing in health care settings. The Revised

More information

SPORTS INSURANCE PROPOSAL FORM (All questions must be answered in ink)

SPORTS INSURANCE PROPOSAL FORM (All questions must be answered in ink) SPORTS INSURANCE PROPOSAL FORM (All questions must be answered in ink) Hanleigh Management Inc. Hanleigh Management, Inc., Hanleigh General Agency, Inc. 50 Tice Blvd., Suite 122, Woodcliff Lake, New Jersey

More information

Appropriate Modifier Usage

Appropriate Modifier Usage Anatomical modifiers Anesthesia modifiers EA, EB and EC FB, FC and FD Anatomical modifiers are used to indicate that a procedure or service was performed at a specific anatomic site or to indicate that

More information

Oxford Medicare Advantage Supplement (May apply to providers in CT, NJ, NY; refer to your agreement for applicability)

Oxford Medicare Advantage Supplement (May apply to providers in CT, NJ, NY; refer to your agreement for applicability) Oxford Medicare Advantage Supplement (May apply to providers in CT, NJ, NY; refer to your agreement for applicability) Important information regarding the use of this supplement This Oxford Medicare Supplement

More information

Excision of Lesions. Brenda Chidester-Palmer CPC, CPC-I, CEMC, CASCC, CCS-P. All Rights Reserved. Objectives

Excision of Lesions. Brenda Chidester-Palmer CPC, CPC-I, CEMC, CASCC, CCS-P. All Rights Reserved. Objectives Excision of Lesions Surgical Approach Brenda Chidester-Palmer CPC, CPC-I, CEMC, CASCC, CCS-P 1 Objectives In this session we will discuss Lesion categories Removal versus biopsy Different lesion removal

More information

2015 Medicare Advantage Summary of Benefits

2015 Medicare Advantage Summary of Benefits 2015 Medicare Advantage Summary of Benefits HNE Medicare Premium No Rx and HNE Medicare Basic No Rx January 1, 2015 - December 31, 2015 H8578_2015_034 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2015

More information

The CPT code for Human papillomavirus (HPV) has changed from 87621 to 87624. This code (87624) covers testing for HPV High Risk genotypes.

The CPT code for Human papillomavirus (HPV) has changed from 87621 to 87624. This code (87624) covers testing for HPV High Risk genotypes. January 2015 2015 CPT Code Updates Dear Client: The American Medical Association (AMA) publishes the Current Procedural Terminology (CPT) Coding Manual on an annual basis. For 2015, the AMA made several

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3952 Y0041_H3952_KS_15_18734 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

CUSTOM SOFTWARE SYSTEMS, INC

CUSTOM SOFTWARE SYSTEMS, INC MODIFIERS 4 21 PROLONGED EVALUATION AND MANAGEMENT SERVICES 5 22 UNUSUAL PROCEDURAL SERVICES 6 23 UNUSUAL ANESTHESIA 7 24 UNRELATED EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN DURING A POSTOPERATIVE

More information

Benefits Matrix for Adults Covered and Non-Covered Services

Benefits Matrix for Adults Covered and Non-Covered Services Covered and Non-Covered Services UniCare Health Plan of West Virginia, Inc. Medicaid Managed Care The matrix below lists the available benefits for adults enrolled in West Virginia Medicaid. These benefits

More information

Objective of This Lecture

Objective of This Lecture Component 2: The Culture of Health Care Unit 3: Health Care Settings The Places Where Care Is Delivered Lecture 5 This material was developed by Oregon Health & Science University, funded by the Department

More information

Substance Abuse Prevention Program

Substance Abuse Prevention Program Planning, Design and Construction 14528 S Outer Forty Suite 100 Chesterfield, MO 63017 (314) 628-3494 (314) 628-3715 Substance Abuse Prevention Program REFERENCES: In an effort to create a safe workplace,

More information

ST. VINCENT'S. MEDICAL CENTER St. Vincent's Healthcare

ST. VINCENT'S. MEDICAL CENTER St. Vincent's Healthcare ST. VINCENT'S MEDICAL CENTER St. Vincent's Healthcare Medical Technology St. Vincent s Schools of Medical Science Throughout Northeast Florida and Southern Georgia, St. Vincent s HealthCare is well known

More information

Medicaid Family Planning Waiver Services CPT Codes and ICD-9 Diagnosis Codes

Medicaid Family Planning Waiver Services CPT Codes and ICD-9 Diagnosis Codes Family Planning Waiver Services CPT Codes and ICD-9 Diagnosis Codes CPT Code Description of Covered Codes Evaluation and Management 99384FP 99385FP 99386FP 99394FP 99395FP 99396FP 99401FP 99402FP 99403FP

More information

IN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services)

IN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services) HMO-OA-CNT-30-45-500-500D-13 HMO Open Access Contract Year Plan Benefit Summary This is a brief summary of benefits. Refer to your Membership Agreement for complete details on benefits, conditions, limitations

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3909 Y0041_H3909_PC_15_18889 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

Miscellaneous Services

Miscellaneous Services Miscellaneous Services Acute Physical Medicine and Rehabilitation (Acute PM&R) Inpatient PM&R is limited to Department-contracted facilities. Please see the Department s Acute PM&R Billing Instructions

More information

June 2016 Updated Crosswalk:

June 2016 Updated Crosswalk: June 2016 Updated Crosswalk: 2016 HCPCS G0279 G6001 G6002 G6003 G6004 deleted f Radiology Coding BCBSNC currently considers this service investigational and will not cover either the HCPCS CPT s. Diagnostic

More information

Part B Education Exclusive: Modifier 59 Edit Update Questions

Part B Education Exclusive: Modifier 59 Edit Update Questions Cahaba GBA would like to provide some clarification of the use of Modifier 59. The modifier is not limited to National Correct Coding Initiative (NCCI) pairs. We apologize for any confusion our July article

More information

Empire BlueCross BlueShield Professional Reimbursement Policy

Empire BlueCross BlueShield Professional Reimbursement Policy Pressional Reimbursement Policy Subject: Bundled Services and Supplies NY Policy: 0008 Effective: 01/01/2014-02/23/2014 Coverage is subject to the terms, conditions, and limitations an individual member

More information

Veterinary Testing. Classes of Test

Veterinary Testing. Classes of Test Veterinary Testing Classes of Test July 2014 Copyright National Association of Testing Authorities, Australia 2014 This publication is protected by copyright under the Commonwealth of Australia Copyright

More information

3.1. The procedure shall be applicable to all University employees.

3.1. The procedure shall be applicable to all University employees. LINCOLN UNIVERSITY Procedure: Confirmatory Testing for Substance Abuse Procedure Number: HRM 113p Effective Date: October 2008 Revisions: Review Officer: Chief Human Resources Officer 1. Purpose 1.1. It

More information

Local Coverage Determination (LCD) for Skin Lesion (Non-Melanoma) Removal (L28300)

Local Coverage Determination (LCD) for Skin Lesion (Non-Melanoma) Removal (L28300) Search Home Medicare Medicaid CHIP About CMS Regulations & Guidance Research, Statistics, Data & Systems Outreach & Education People with Medicare & Medicaid Questions Careers Newsroom Contact CMS Acronyms

More information

Rapid Screening Tests

Rapid Screening Tests Rapid Screening Tests Infectious Diseases Cardiac Marker Tumor Markers Pregnancy Rheumatology Allergy Drugs of Abuse > For rapid and cost-effective diagnosis > Accurate, reliable results > Easy to use

More information

AI CPT Codes. x x. 70336 MRI Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)

AI CPT Codes. x x. 70336 MRI Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) Code Category Description Auth Required Medicaid Medicare 0126T IMT Testing Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor

More information

Section 2. Licensed Nurse Practitioner

Section 2. Licensed Nurse Practitioner Section 2 Table of Contents 1 General Information... 2 1-1 General Policy... 2 1-2 Fee-For-Service or Managed Care... 2 1-3 Definitions... 2 2 Provider Participation Requirements... 3 2-1 Provider Enrollment...

More information

Provider Type 34 Billing Guide

Provider Type 34 Billing Guide Therapy Where to find state policy The Medicaid Services Manual (MSM) Chapter 1700 contains State policy for all therapy services, including respiratory therapy services (not discussed here. See MSM Chapter

More information

Shipping of Infectious Substances and Patient Specimens

Shipping of Infectious Substances and Patient Specimens Shipping of Infectious Substances and Patient Specimens If you ship infectious substances or patient specimens you should be aware of the International Air Transport Association (IATA) Dangerous Goods

More information

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200 GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung

More information

The Deductible is applicable to all covered services except for flat dollar Copayment services.

The Deductible is applicable to all covered services except for flat dollar Copayment services. PRIORITY HEALTH www.priorityhealth.com/mpsers PRIORITYHMO SM PLUS PLAN MICHIGAN PUBLIC SCHOOL EMPLOYEES RETIREMENT SYSTEM (MPSERS) Effective January 1, 2016 through December 31, 2016 The HMO Plus plan

More information

CPT Code Changes for 2013

CPT Code Changes for 2013 CPT Code Changes for 2013 RADIOLOGY Cathy Woodall, CHC, CPC Nicholas Parish, CHC Compliance-Radiology McKesson Revenue Management Solutions This commentary is a summary prepared by McKesson s Revenue Management

More information

Flexible Blue SM Plan 2 Medical Coverage with Flexible Blue SM RX Prescription Drugs Benefits-at-a-Glance for Western Michigan Health Insurance Pool

Flexible Blue SM Plan 2 Medical Coverage with Flexible Blue SM RX Prescription Drugs Benefits-at-a-Glance for Western Michigan Health Insurance Pool Flexible Blue SM Plan 2 Medical Coverage with Flexible Blue SM RX Prescription Drugs Benefits-at-a-Glance for Western Michigan Health Insurance Pool The information in this document is based on BCBSM s

More information

MRI EXAM CPT CODE REFERENCE

MRI EXAM CPT CODE REFERENCE I EXAM REFERENCE Use this reference to quickly determine the correct exam for your patients based on the indications described herein and the for the order. Creatine levels should be obtained prior to

More information

January 1, 2015 December 31, 2015 Summary of Benefits. Altius Advantra (HMO) H8649-003 80.06.361.1-UTWY A

January 1, 2015 December 31, 2015 Summary of Benefits. Altius Advantra (HMO) H8649-003 80.06.361.1-UTWY A January, 205 December 3, 205 Summary of Benefits H8649-003 80.06.36.-UTWY A Y0022_205_H8649_003_UT_WYa Accepted /204 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of

More information

CENTRAL MICHIGAN UNIVERSITY - Premier Plan (PPO1) 007000285-0002 0004 Effective Date: July 1, 2015 Benefits-at-a-Glance

CENTRAL MICHIGAN UNIVERSITY - Premier Plan (PPO1) 007000285-0002 0004 Effective Date: July 1, 2015 Benefits-at-a-Glance CENTRAL MICHIGAN UNIVERSITY - Premier Plan (PPO1) 007000285-0002 0004 Effective Date: July 1, 2015 Benefits-at-a-Glance This is intended as an easy-to-read summary and provides only a general overview

More information

Radiography. 1. Introduction. 2. Documentation of Compliance. 3. Didactic Competency Requirements. 4. Clinical Competency Requirements

Radiography. 1. Introduction. 2. Documentation of Compliance. 3. Didactic Competency Requirements. 4. Clinical Competency Requirements PRIMARY CERTIFICATION DIDACTIC AND CLINICAL COMPETENCY REQUIREMENTS EFFECTIVE JANUARY 2012 Radiography 1. Introduction Candidates for certification and registration are required to meet the Professional

More information

FRIEND TO FRIEND CPT CODES 2015 2016. Diagnostic digital breast tomosynthesis, unilateral (list separately in addition to code for primary procedure)

FRIEND TO FRIEND CPT CODES 2015 2016. Diagnostic digital breast tomosynthesis, unilateral (list separately in addition to code for primary procedure) FRIEND TO FRIEND CPT CODES 2015 2016 CPT CODE SERVICE DESCRIPTION FEE EFFECTIVE G0101 Screening pelvic examination $36.69 01 Jan 16 G0202 Mammography, screening, digital, bilateral (2 view film study of

More information

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY P.O. Box 1365, Columbia, South Carolina 29202 1-800-325-4368

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY P.O. Box 1365, Columbia, South Carolina 29202 1-800-325-4368 COLONIAL LIFE & ACCIDENT INSURANCE COMPANY P.O. Box 1365, Columbia, South Carolina 29202 1-800-325-4368 SPECIFIED DISEASE COVERAGE OUTLINE OF COVERAGE (Applicable to Policy Form C1000-PA-R) THIS POLICY

More information

Coding and Payment Guide for Laboratory Services. An essential coding, billing, and payment resource for laboratory and pathology services

Coding and Payment Guide for Laboratory Services. An essential coding, billing, and payment resource for laboratory and pathology services Coding and Payment Guide for Laboratory Services An essential coding, billing, and payment resource for laboratory and pathology services Contents Introduction............................... 1 Coding Systems...............................

More information

PLAN DESIGN AND BENEFITS - New York Open Access EPO 1-10/10

PLAN DESIGN AND BENEFITS - New York Open Access EPO 1-10/10 PLAN FEATURES Deductible (per calendar year) $1,000 Individual $3,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Member cost sharing for certain services,

More information

Countryway Insurance Company P.O. Box 4851, Syracuse, New York 13221-4851

Countryway Insurance Company P.O. Box 4851, Syracuse, New York 13221-4851 Dear Insured: Please read this letter carefully because it provides specific information concerning how a medical claim under personal injury protection coverage will be handled, including specific requirements

More information

FEATURES NETWORK OUT-OF-NETWORK

FEATURES NETWORK OUT-OF-NETWORK Schedule of Benefits Employer: The Vanguard Group, Inc. ASA: 697478-A Issue Date: January 1, 2014 Effective Date: January 1, 2014 Schedule: 3B Booklet Base: 3 For: Choice POS II - 950 Option - Retirees

More information

Canine Lymphoma Frequently Asked Questions by Pet Owners

Canine Lymphoma Frequently Asked Questions by Pet Owners Canine Lymphoma Frequently Asked Questions by Pet Owners What is lymphoma? The term lymphoma describes a diverse group of cancers in dogs that are derived from white blood cells called lymphocytes. Lymphocytes

More information

The Immune System and Disease

The Immune System and Disease Chapter 40 The Immune System and Disease Section 40 1 Infectious Disease (pages 1029 1033) This section describes the causes of disease and explains how infectious diseases are transmitted Introduction

More information

Modifiers. Page 1 of 6

Modifiers. Page 1 of 6 Modifiers A Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) modifier is a twocharacter (alpha and/or numeric) code appended to a CPT/HCPCS procedure code to clarify

More information

Procedure. 2 29827 $ 3,560 $ 1,476 Arthroscopy, shoulder, surgical; with rotator cuff repair 5.5% 241.1%

Procedure. 2 29827 $ 3,560 $ 1,476 Arthroscopy, shoulder, surgical; with rotator cuff repair 5.5% 241.1% Exhibit 1 Top 50% of Payments for Surgical s (Physician costs) On average, Workers' payments for Surgical s in are 256% the average allowed claim costs for Healthcare in. $6,000 $5,000 $4,000 Allowed Claim

More information

Laboratory Services Policy

Laboratory Services Policy Policy Number 2014R0014F Annual Approval Date Laboratory Services Policy 1/27/2014 Approved By National Reimbursement Forum United HealthCare Community & State Payment Policy Committee IMPORTANT NOTE ABOUT

More information

Urine Drug Testing. Why drug test? Set the Standard!

Urine Drug Testing. Why drug test? Set the Standard! Urine Drug Testing Urine drug testing is a valuable tool for the physician when making treatment decisions. Patients and physicians benefit from safe and effective treatment of pain but there are always

More information

HNE Premier 1 (HMO) and HNE Premier 2 (HMO)

HNE Premier 1 (HMO) and HNE Premier 2 (HMO) 2016 Medicare Advantage Summary of Benefits HNE Premier 1 (HMO) and HNE Premier 2 (HMO) January 1, 2016 - December 31, 2016 H8578_2016_429 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2016 SECTION I

More information

Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2015

Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2015 Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2015 About this chart: This chart is to be used as a guide only and does not contain all details or exclusions.

More information

New York Small Group Indemnity Aetna Life Insurance Company Plan Effective Date: 10/01/2010. PLAN DESIGN AND BENEFITS - NY Indemnity 1-10/10*

New York Small Group Indemnity Aetna Life Insurance Company Plan Effective Date: 10/01/2010. PLAN DESIGN AND BENEFITS - NY Indemnity 1-10/10* PLAN FEATURES Deductible (per calendar year) $2,500 Individual $7,500 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Member cost sharing for certain services,

More information

[2015] SUMMARY OF BENEFITS H1189_2015SB

[2015] SUMMARY OF BENEFITS H1189_2015SB [2015] SUMMARY OF BENEFITS H1189_2015SB Section I You have choices in your health care One choice is to get your Medicare benefits through Original Medicare (fee-for-service Medicare). Original Medicare

More information

surg urin Surgery: Urinary System 1

surg urin Surgery: Urinary System 1 Surgery: Urinary System 1 This section contains information to assist providers in billing for surgical procedures related to the urinary system. Extracorporeal Shock Wave Lithotripsy Medi-Cal covers Extracorporeal

More information

For Examiner Only Case Minor complaint with substance abuse issues Author; John Rose, MD Reviewer; Douglas Char, MD Approved; 10/26/05

For Examiner Only Case Minor complaint with substance abuse issues Author; John Rose, MD Reviewer; Douglas Char, MD Approved; 10/26/05 For Examiner Only Case Minor complaint with substance abuse issues Author; John Rose, MD Reviewer; Douglas Char, MD Approved; 10/26/05 CONTENT AREA Psychiatric/ Behavioral/Substance abuse ORAL CASE SUMMARY

More information

PRIORITY HEALTH priorityhealth.com HealthbyChoice Incentives Summary of Benefits TRINITY HEALTH -HbCI 2 1/1/13 12/31/13

PRIORITY HEALTH priorityhealth.com HealthbyChoice Incentives Summary of Benefits TRINITY HEALTH -HbCI 2 1/1/13 12/31/13 PRIORITY HEALTH priorityhealth.com Healthby Incentives Summary of Benefits TRINITY HEALTH -HbCI 2 1/1/13 12/31/13 The Healthby Incentives HMO plan is a Consumer Engaged Health plan that offers a choice

More information

Coventry Health and Life Insurance Company PPO Schedule of Benefits

Coventry Health and Life Insurance Company PPO Schedule of Benefits State(s) of Issue: Oklahoma PPO Plan: OI08C30050 30 Coventry Health and Life Insurance Company PPO Schedule of Benefits Covered Services Contract Year Deductible For All Eligible Expenses (unless otherwise

More information

Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost. Amendment Regulations (No 2) 2004

Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost. Amendment Regulations (No 2) 2004 Amendment Regulations (No 2) 2004 Pursuant to section 324 of the and Compensation Act 2001, Her Excellency the Governor General, acting on the advice and with the consent of the Executive Council, makes

More information

Diagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University

Diagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Diagnosis of HIV-1 Infection Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Tests Used to Diagnose HIV-1 Infection HIV antibody (today s topic) HIV p24 antigen HIV DNA HIV

More information

Summary of Benefits Community Advantage (HMO)

Summary of Benefits Community Advantage (HMO) Summary of Benefits Community Advantage (HMO) January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover or list

More information

Dickinson Wright, PLLC 03956-006

Dickinson Wright, PLLC 03956-006 Dickinson Wright, PLLC 03956-006 Flexible Blue SM Plan 3 Medical Coverage with Preventive Care and Mammography Benefits Benefits-at-a-Glance This is intended as an easy-to-read summary and provides only

More information

Covered Benefits. Covered. Must meet current federal and state guidelines. Abortions. Covered. Allergy Testing. Covered. Audiology. Covered.

Covered Benefits. Covered. Must meet current federal and state guidelines. Abortions. Covered. Allergy Testing. Covered. Audiology. Covered. Covered Benefits Services Abortions Allergy Testing Audiology Birth Control Services Blood & Blood Plasma Bone Mass Measurement (bone density) Case Management Chemotherapy Chiropractor Services (manipulation/subluxation)

More information

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after

More information

Independent Health s Medicare Passport Advantage (PPO)

Independent Health s Medicare Passport Advantage (PPO) Independent Health s Medicare Passport Advantage (PPO) (a Medicare Advantage Preferred Provider Organization Option (PPO) offered by INDEPENDENT HEALTH BENEFITS CORPORATION with a Medicare contract) Summary

More information

Name Date Class. This section explains what kinds of organisms cause infectious disease and how infectious diseases are spread.

Name Date Class. This section explains what kinds of organisms cause infectious disease and how infectious diseases are spread. Fighting Disease Name Date Class Infectious Disease This section explains what kinds of organisms cause infectious disease and how infectious diseases are spread. Use Target Reading Skills Before you read,

More information

please refer to our internet site, www.harvardpilgrim.org, or contact the Member Services

please refer to our internet site, www.harvardpilgrim.org, or contact the Member Services Schedule of s HPHC Insurance Company, Inc. THE HPHC INSURANCE COMPANY PPO PLAN MAINE ID: MD0000000750_F2 X This Schedule of s summarizes your benefits under The HPHC Insurance Company PPO Plan (the Plan)

More information

C. The prospective employee must thoroughly read the LFCC Pre-Employment Drug

C. The prospective employee must thoroughly read the LFCC Pre-Employment Drug Pre-Employment Drug Screening Policy Policy No. 40001 Effective Date March 2006 Revision Date Revision No. Approved: John J. Ski Sygielski and President s Cabinet Date: March 2006 1.0 Purpose Substance

More information

Professional/Technical Component Policy

Professional/Technical Component Policy Policy Number 2015R0012C Professional/Technical Component Policy Annual Approval Date 1/27/2014 Approved By Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible

More information

Covered Service Description

Covered Service Description Advanced registered nurse practitioner (ARNP) Ambulatory surgical center (ASC) These are given by an ARNP who s licensed to practice in the State of Florida The ARNP and a doctor must make decisions about

More information

Spina Bifida Occulta. Lo-Call 1890 20 22 60. Occulta Means Hidden

Spina Bifida Occulta. Lo-Call 1890 20 22 60. Occulta Means Hidden Occulta Means Hidden Spina Bifida Occulta is not easily detected because skin covers the area, such as the spinal cord, spinal bone or nerve roots, which may be affected. Spina Bifida Occulta can affect

More information

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Introduction Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a phenomenon that more commonly affects older males. It is associated

More information

Michigan Electrical Employees Health Plan Benefits & Eligibility-at-a Glance Supplement to Medicare - Medicare Enrollees

Michigan Electrical Employees Health Plan Benefits & Eligibility-at-a Glance Supplement to Medicare - Medicare Enrollees Medicare Coverage BCBSM Supp Coverage Preventive Services 12 months, if age 50 and older Colonoscopy - one per calendar year 1 0 years (if at high risk every 24 months) approved amount**, once per flu

More information

MEDICAL MANAGEMENT POLICY

MEDICAL MANAGEMENT POLICY TITLE: Scar Revision/Keloid PAGE: 1of 9 This Medical policy is not a guarantee of benefits or coverage, nor should it be deemed as medical advice. In the event of any conflict concerning benefit coverage,

More information

Schedule of Benefits HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS MEMBER COST SHARING

Schedule of Benefits HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS MEMBER COST SHARING Schedule of s HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS ID: MD0000003378_ X Please Note: In this plan, Members have access to network benefits only from the providers in the Harvard Pilgrim-Lahey

More information

CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE

CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE Phone: 800-609-1108 Email: codmanpump@aol.com Fax: 303-703-1572

More information