FY 2016 BCCCNP Procedure Code Reference Chart

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "FY 2016 BCCCNP Procedure Code Reference Chart"

Transcription

1 77057 G G G0204 G0279 FY 2016 Procedure Reference Chart Screening mammography, bilateral (two view film study of each breast) Screening mammography producing direct digital image, bilateral, all views Digital Screening Breast Tomosynthesis (Bilateral) Mammography; unilateral Diagnostic mammography, producing direct digital image, unilateral, all views Mammography; bilateral Diagnostic mammography, producing direct digital image, bilateral, all views Digital Diagnostic Breast Tomosynthesis (Bilateral) Service Billable with ( Definition) Screening mammogram Two views of each breast Performed on an asymptomatic woman Digital screening mammogram Two views of each breast Performed on an asymptomatic woman Digital Screening Breast Tomosynthesis (Bilateral) Performed in conjunction with digital screening mammography Diagnostic mammogram Two or more views of one breast Performed on a symptomatic woman Digital diagnostic mammogram Two or more views of one breast Performed on a symptomatic woman Diagnostic mammogram Two or more views of each breast Performed on a symptomatic woman Digital diagnostic mammogram Two or more views of each breast Performed on a symptomatic woman Digital Screening Breast Tomosynthesis (Bilateral) Performed in conjunction with digital diagnostic mammography FY16 1

2 Procedure Reference Chart Cytopathology, cervical or vaginal (any reporting system); requiring interpretation by physician (List separately in addition to code for technical service) Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening, under physician supervision Service Billable with ( Definition) Pap test Laboratory professional services Use in conjunction with codes 88142, 88143, 88164, when physician interpretation of Pap test is required Thin Prep Pap test Laboratory technical services Manual screening Professional component indicated by when physician interpretation required Thin Prep Pap test - Rescreening Laboratory technical services Manual screening Professional component indicted by when physician interpretation required Conventional Pap test Laboratory technical services Professional component indicated by when physician interpretation required Conventional Pap test Rescreening Laboratory technical services Professional component indicated by when physician interpretation required Thin Prep Pap test Laboratory technical services Automated screening Thin Prep Pap test - Rescreening Laboratory technical services Automated screening with manual rescreening FY16 2

3 Procedure Reference Chart G0123 G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision. Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician. G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, amplified probe technique Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a problem focused history; a problem focused examination; and straight forward medical decision making. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually, the presenting problems are self limited or minor. Providers typically spend 10 minutes face-to-face with the patient and/or family. Service Billable with ( Definition) Thin Prep Pap test Laboratory technical services Automated screening Thin Prep Pap test Automated screening Professional component indicated by when physician interpretation required Thin Prep Pap test Laboratory technical services Automated screening with manual rescreening HPV typing of high-risk strain Partial annual clinical exam Either CBE only OR pelvic/pap only Symptomatic or diagnosed new patient FY16 3

4 Procedure Reference Chart Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: an expanded problem focused history; an expanded problem focused examination; and straight forward medical decision making. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually, the presenting problem(s) are of low to moderate severity. Providers typically spend 20 minutes face-to-face with the patient and/or family Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a detailed history; a detailed examination; and medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually the presenting problem(s) are of moderate severity. Providers typically spend 30 minutes face-to-face with the patient and/or family. Service Billable with ( Definition) Partial annual clinical exam Either CBE only OR pelvic/pap only Symptomatic or diagnosed new patient OR colposcopy office visit Symptomatic or diagnosed new patient FY16 4

5 Procedure Reference Chart Breast or Cervical Consultation Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually the presenting problem(s) are of moderate to high severity. Providers typically spend 45 minutes face-to-face with the patient and/or family Breast or Cervical Consultation Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually the presenting problem(s) are of moderate to high severity. Providers typically spend 60 minutes face-to-face with the patient and/or family Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services. Service Billable with ( Definition) Symptomatic or diagnosed new patient Symptomatic or diagnosed new patient Partial annual clinical exam Either CBE only OR pelvic/pap only (including repeat Paps) FY16 5

6 Procedure Reference Chart Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three components: a problem focused history; a problem focused examination; straight forward medical decision making. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually, the presenting problem(s) are self limited or minor. Providers typically spend 10 minutes face-to-face with the patient and/or family Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are and/or family s needs. Usually, the presenting problem(s) are of low to moderate severity. Providers typically spend 15 minutes face-to-face with the patient and/or family. Service Billable with ( Definition) Partial annual clinical exam Either CBE only OR pelvic/pap only (includes repeat Paps) Symptomatic or diagnosed established patient FY16 6

7 Procedure Reference Chart Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history; a detailed examination; medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually the presenting problem(s) are of moderate to high severity. Providers typically spend 25 minutes face-to-face with the patient and/or family Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are and/or family s needs. Usually the presenting problem(s) are of moderate to high severity. Providers typically spend 40 minutes face-to-face with the patient and/or family Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; years Service Billable with ( Definition) Symptomatic or diagnosed established patient Symptomatic or diagnosed established patient Cervical Consult on day of colposcopy FY16 7

8 Procedure Reference Chart Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; years Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; 65 years and over Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; years Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; years Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; 65 years and over Service Billable with ( Definition) Asymptomatic new patient between the ages of 40 and 64 Asymptomatic new patient age 65 and older Cervical Consult on day of colposcopy Asymptomatic established patient between the ages of 40 and 64 CBE AND pelvic/pap(if due for Pap test) Asymptomatic established patient age 65 and older Urine pregnancy test Urine pregnancy test; with colposcopy Colposcopy of the cervix including upper/adjacent vagina Colposcopy Office visit billed separately FY16 8

9 Procedure Reference Chart Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage Endocervical curettage (not done as part of a dilation and curettage) Fine needle aspiration; without imaging guidance Fine needle aspiration; with imaging guidance Puncture aspiration of cyst of breast Service Billable with ( Definition) Colposcopy with biopsy of the cervix and endocervical curettage Office visit billed separately Colposcopy with biopsy of the cervix Office visit billed separately Colposcopy with endocervical curettage Office visit billed separately ECC Endocervical curettage Not part of D & C Fine needle aspiration of superficial breast tissue Not using imaging guidance Fine needle aspiration of superficial breast tissue Using imaging guidance Puncture aspiration, breast cyst FY16 9

10 Procedure Reference Chart Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure); (Use in conjunction with code 19000) Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance Each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19081) Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance Each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19083) Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance Each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19085) Service Billable with ( Definition) Puncture aspiration, breast cyst Each additional cyst Stereotactic localization placement of metallic clip during breast biopsy Stereotactic localization placement of metallic clip during breast biopsy Each additional lesion Ultrasonic guidance placement of metallic localization clip during breast biopsy Imaging supervision and interpretation Ultrasonic guidance placement of metallic localization clip during breast biopsy Imaging supervision and interpretation Each additional lesion Magnetic resonance guidance placement of metallic localization clip during breast biopsy Imaging supervision and interpretation Magnetic resonance guidance placement of metallic localization clip during breast biopsy Imaging supervision and interpretation Each additional lesion FY16 10

11 Procedure Reference Chart Biopsy of breast; percutaneous, needle core, not using imaging guidance Biopsy of breast; open, incisional Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion, open, male or female, one or more lesions Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (List separately in addition to code for primary procedure); (Use in conjunction with code 19125) Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance Each additional lesion, including mammographic guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19281) Service Billable with ( Definition) Breast biopsy, needle core Not using imaging guidance Breast biopsy, incisional Breast biopsy, excisional Breast biopsy, excision of single lesion identified by radiological marker Breast biopsy, excision of lesion identified by radiological marker Each additional lesion Mammographic localization guidance for needle placement Mammographic localization guidance for needle placement Each additional lesion FY16 11

12 Procedure Reference Chart Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance Each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19283) Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance Each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19285) Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance Each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure) (Use in conjunction with 19287) Radiological examination, surgical specimen Service Billable with ( Definition) Stereotactic localization guidance for needle placement Stereotactic localization guidance for needle placement Each additional lesion Ultrasonic guidance of breast needle placement Imaging supervision and interpretation Ultrasonic guidance of breast needle placement Imaging supervision and interpretation Each additional lesion Magnetic resonance guidance for needle placement Magnetic resonance guidance for needle placement Each additional lesion Radiological examination, surgical specimen FY16 12

13 FY 2016 Procedure Reference Chart Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation Ultrasound, breast(s) (unilateral or bilateral), Complete exam, including axilla -Technical Component Ultrasound, breast(s) (unilateral or bilateral), Limited exam, including axilla -Technical Component Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation Level IV Surgical pathology, gross and microscopic examination; Breast, biopsy, not requiring microscopic evaluation of surgical margins; Cervix, biopsy Level V Surgical pathology; gross and microscopic examination; Breast, excision of lesion, requiring microscopic evaluation of surgical margins; Cervix, conization Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain -Technical component Service Billable with ( Definition) Magnetic resonance guidance for needle placement Breast ultrasound Breast ultrasound Ultrasonic guidance of breast needle placement Imaging supervision and interpretation Breast or cervical biopsy, laboratory evaluation of tissue sample Level IV Breast or cervical biopsy, laboratory evaluation of tissue sample Level V Immunohistochemistry or immunocytochemistry FY16 13

14 FY 2016 Procedure Reference Chart Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) -Technical component Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy of specimen(s) Cytopathology, evaluation of fine needle aspirate; interpretation and report Cytopathology, Selective Cellular Enhancement Technique with Interpretation (e.g. Liquid Based Slide Preparation Method), except Cervical or Vaginal **Cannot bill in conjunction with 88173** -Technical component G9012 Unlisted evaluation and management Patient Navigation Service Billable with ( Definition) Immunohistochemistry or immunocytochemistry Each additional specimen or stain Cytopathology, evaluation of fine needle aspirate to determine specimen adequacy Cytopathology, evaluation of fine needle aspirate Interpretation and report Cytopathology, Selective Cellular Enhancement Technique with Interpretation Interpretation and reports FY16 14

15 Procedure Reference Chart AA -AD -QK -QX -QY -QZ Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified -Anesthesia service performed personally by anesthesiologist -Medical supervision by a physician: more than four concurrent anesthesia procedures -Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals -CRNA service: with medical direction by a physician -Anesthesiologist medically directs one CRNA -CRNA service: (supervised) without medical direction by a physician Cone - Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser **Cannot bill in conjunction with Cone - Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser; loop electrode excision **Cannot bill in conjunction with Service Billable with ( Definition) Anesthesia CPT code used when billing for Breast biopsy, excisional (19120 or 19125) Anesthesia service performed personally by anesthesiologist Medical supervision by a physician: more than four concurrent anesthesia procedures Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals CRNA service: with medical direction by a physician Anesthesiologist medically directs one CRNA CRNA service: (supervised) without medical direction by a physician Cone - Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser Cannot bill in conjunction with Cone - Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser; loop electrode excision Cannot bill in conjunction with FY16 15

16 Procedure Reference Chart EMB - Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method **Cannot bill in conjunction with EMB - Endometrial sampling (biopsy) performed in conjunction with a colposcopy (List separately in addition to code for primary procedure ~ (Colposcopy 57452, 57454, 57455, 57456)) **Cannot bill in conjunction with LEEP - Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix **Cannot bill in conjunction with LEEP - Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix **Cannot bill in conjunction with MRI Breast, with and/or without contrast, Unilateral -Technical component MRI Breast, with and/or without contrast, Bilateral -Technical component Service Billable with ( Definition) EMB - Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method Cannot bill in conjunction with EMB - Endometrial sampling (biopsy) performed in conjunction with a colposcopy (List separately in addition to code for primary procedure ~ Colposcopy 57452, 57454, 57455, 57456)) Cannot bill in conjunction with LEEP - Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix Cannot bill in conjunction with LEEP - Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix Cannot bill in conjunction with MRI Breast, with and/or without contrast Unilateral MRI Breast, with and/or without contrast Bilateral FY16 16

17 Procedure Reference Chart Biopsy of Skin, Subcutaneous tissue and/or mucous membrane Excisional procedure: Breast nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct Ultrasound; Axilla -Technical component Mammary Ductogram or Galactogram, Single Duct, Radiological Supervision and Interpretation -Technical component Mammary Ductogram or Galactogram, Multiple Ducts, Radiological Supervision and Interpretation -Technical component Service Billable with ( Definition) Biopsy of Skin, Subcutaneous tissue and/or mucous membrane Excisional procedure: Breast nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct Ultrasound; Axilla Mammary Ductogram or Galactogram, Single Duct, Radiological Supervision and Interpretation Mammary Ductogram or Galactogram, Multiple Ducts, Radiological Supervision and Interpretation FY16 17

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

FY 2016 BCCCNP Unit Cost Reimbursement Rate Schedule

FY 2016 BCCCNP Unit Cost Reimbursement Rate Schedule Unit Cost Reimbursement Schedule 1 Screening Mammogram (Bilateral) Service CPT Code FY16 2 Digital Screening Mammogram (Bilateral) 3 Diagnostic Mammogram (Unilateral) 4 Digital Diagnostic Mammogram (Unilateral)

More information

Provider Reimbursement for Women's Cancer Screening Program

Provider Reimbursement for Women's Cancer Screening Program Reimbursement Schedule July 1, 2015 June 30, 2016 Office Visits - Established Patients Office Visit / Minimal / no physician 99211 $ 16.70 Office Visit / Problem focused History / exam 99212 $ 36.46 Preventive

More information

Office Visits. Breast

Office Visits. Breast Early Detection Works Reimbursement Fee Schedule Effective for services on or after July 1, 2015 Program guidelines require that be the payor of last resort. Program funds cannot be used to supplement

More information

Allowable CPT Codes for the Illinois Breast and Cervical Cancer Program FOR INTERNAL USE ONLY Effective February 1, 2013

Allowable CPT Codes for the Illinois Breast and Cervical Cancer Program FOR INTERNAL USE ONLY Effective February 1, 2013 Allowable CPT s for the Illinois Breast and Cervical Cancer Program OR INTERNAL USE ONLY Effective ebruary 1, 2013 Screening services should include CBE, pelvic exam, mammogram and Pap test. Every screening

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

CPT 2014 Updates. January, 17, 2014

CPT 2014 Updates. January, 17, 2014 CPT 2014 Updates January, 17, 2014 Summary of 2014 CPT Changes ** 175 New Codes ** ** 107 Revised Codes ** ** 53 Deleted Codes ** CPT Sections with Changes Integumentary Musculoskeletal Respiratory Cardiovascular

More information

OBJECTIVES By the end of this segment, the community participant will be able to:

OBJECTIVES By the end of this segment, the community participant will be able to: Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway

More information

Q: What differentiates a diagnostic from a screening mammography procedure?

Q: What differentiates a diagnostic from a screening mammography procedure? The following Q&As address Medicare guidelines on the reporting of breast imaging procedures. Private payer guidelines may vary from Medicare guidelines and from payer to payer; therefore, please be sure

More information

Solving the Cytology Coding Puzzle. Carol A. Filomena, MD Director of Pathology Duke Raleigh Hospital

Solving the Cytology Coding Puzzle. Carol A. Filomena, MD Director of Pathology Duke Raleigh Hospital Solving the Cytology Coding Puzzle Carol A. Filomena, MD Director of Pathology Duke Raleigh Hospital Conference Objectives Learn how to appropriately code cervical/vaginal (Pap) Tests and associated ancillary

More information

Cervical Cancer The Importance of Cervical Screening and Vaccination

Cervical Cancer The Importance of Cervical Screening and Vaccination Cervical Cancer The Importance of Cervical Screening and Vaccination Cancer Cells Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Sometimes, this

More information

Sage Screening Program. Provider Manual

Sage Screening Program. Provider Manual Sage Screening Program Provider Manual Sage Screening Program Minnesota Department of Health 85 E. 7th Place, Suite 400 P.O. Box 64882 St. Paul, Minnesota 55164-0882 (651) 201-5600 (phone) (651) 201-5601-

More information

CERVICAL CANCER SCREENING

CERVICAL CANCER SCREENING CERVICAL CANCER SCREENING APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE What screening should be done? NCQA ACCEPTED CODES DOCUMENTATION REQUIREMENTS

More information

Sam & Jennie Bennett Breast Care Center

Sam & Jennie Bennett Breast Care Center Sam & Jennie Bennett Breast Care Center Sam & Jennie Bennett Breast Care Center d Central Maine Medical Center s Sam & Jennie Bennett Breast Care Center is a private place where a woman can find comprehensive

More information

Modifiers 25 and 59. Modifier 25

Modifiers 25 and 59. Modifier 25 Modifiers 25 and 59 This article discusses the appropriate use of modifier 25, Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure

More information

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History

More information

Integumentary System Individual Exercises

Integumentary System Individual Exercises Integumentary System Individual Exercises 1. A physician performs an incision and drainage of a subcutaneous abscess in his office for a particularly uncooperative established patient. How should this

More information

The number following the procedure code is the TRICARE payment group.

The number following the procedure code is the TRICARE payment group. TRICARE/CHAMPUS POLICY MANUAL 6010.47-M JUNE 25, 1999 S POLICY CHAPTER 13 SECTION 9.1 ADDENDUM 1, SECTION 1 TRICARE-APPROVED AMBULATORY SURGERY S - INTEGUMENTARY SYSTEM The number following the procedure

More information

The percentage of women 21-64 years of age who received one or more Pap tests to screen for cervical cancer.

The percentage of women 21-64 years of age who received one or more Pap tests to screen for cervical cancer. Measure Name: Cervical Cancer Screen Owner: NCQA (CCS) Measure Code: CER Lab Data: Y Rule Description: General Criteria Summary The percentage of women 21-64 years of age who received one or more Pap tests

More information

Coding Companion for Radiology. A comprehensive illustrated guide to coding and reimbursement

Coding Companion for Radiology. A comprehensive illustrated guide to coding and reimbursement Coding Companion for Radiology A comprehensive illustrated guide to coding and reimbursement 2013 Contents Getting Started with Coding Companion...i Diagnostic Radiology Head/Neck...1 Chest...38 Spine/Pelvis...51

More information

Cancer of the Cervix

Cancer of the Cervix Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,

More information

Nicole Kounalakis, MD

Nicole Kounalakis, MD Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Goal of Breast Evaluation The goal of breast evaluation is to classify findings as: normal physiologic variations

More information

Coding Companion for Podiatry. A comprehensive illustrated guide to coding and reimbursement

Coding Companion for Podiatry. A comprehensive illustrated guide to coding and reimbursement Coding Companion for Podiatry A comprehensive illustrated guide to coding and reimbursement 2011 Contents Getting Started with Coding Companion...i Integumentary or Skin...1 General Musculoskeletal...61

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

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D.

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D. Breast Cancer: from bedside and grossing room to diagnoses and beyond Adriana Corben, M.D. About breast anatomy Breasts are special organs that develop in women during puberty when female hormones are

More information

Benign Breast Disorders

Benign Breast Disorders Benign Breast Disorders Valerie Swiatkowski, MD Medical Student Lecture Introduction 16% of women ages 40-69 will seek advice from their physician regarding breast complaints over 10 years. Failure to

More information

Explanation of your PAP smear

Explanation of your PAP smear Explanation of your PAP smear Approximately 5-10% of PAP smears in the United States are judged to be abnormal. Too often, the woman who receives this news worries that she already has, or will develop,

More information

BREAST IMAGING H. Lee Moffitt Cancer Center and Research Institute

BREAST IMAGING H. Lee Moffitt Cancer Center and Research Institute BREAST IMAGING H. Lee Moffitt Cancer Center and Research Institute Rotation Director: Margaret Szabunio, M.D. General Goals: On this rotation, the resident will learn to interpret screening mammograms

More information

BREAST MASS Lisa Schmidt, M.P.H., and Eve A. Kerr, M.D.

BREAST MASS Lisa Schmidt, M.P.H., and Eve A. Kerr, M.D. - 71-5. BREAST MASS Lisa Schmidt, M.P.H., and Eve A. Kerr, M.D. The general approach to breast mass work-ups was obtained from opinions of the Committee of Gynecologic Practice of the American College

More information

RADIOLOGY 2014 CPT Codes

RADIOLOGY 2014 CPT Codes RADIOLOGY 2014 CPT Codes Radiology 2014 CPT Codes CMS has issued 36 new procedure codes (one is a radiation therapy code) for CY 2014 that directly pertain to radiology with 26 of those codes the result

More information

Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives

Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives Rotation 1 (Radiology year 1/2) Knowledge Based Objectives: At the end of the rotation, the resident

More information

Breast Disease: Diagnosis and Management

Breast Disease: Diagnosis and Management Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Christina A. Finlayson, MD Professor of Surgery Director, Dianne O Connor Thompson Breast Center Goal of Breast

More information

The society for lower genital tract disorders since 1964.

The society for lower genital tract disorders since 1964. The society for lower genital tract disorders since 1964. Updated Consensus Guidelines for Managing Abnormal Cervical Cancer Screening Tests and Cancer Precursors American Society for and Cervical Pathology

More information

Medicaid Family Planning Waiver Services CPT Codes and ICD-10 Diagnosis Codes

Medicaid Family Planning Waiver Services CPT Codes and ICD-10 Diagnosis Codes CPT Code Description of Covered Codes Evaluation and Management 99384FP 99385FP Family planning new visit 99386FP 99394FP 99395FP Family planning established visit 99396FP 99401FP HIV counseling (pre-test)

More information

ALABAMA BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM PROVIDER MANUAL

ALABAMA BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM PROVIDER MANUAL ALABAMA BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM PROVIDER MANUAL Revised January 2012 1 TABLE OF CONTENTS PROGRAM OVERVIEW.. 3 INTRODUCTION 5 SCREENING ELIGIBILITY GUIDELINES 6 PATIENT RIGHTS..

More information

Benefits Collaborative Policy Statement WOMEN S HEALTH SERVICES

Benefits Collaborative Policy Statement WOMEN S HEALTH SERVICES Page 1 uf 5 The services listed below are not inclusive of all services available to women on Medicaid, but WOMEN S HEALTH SERVICES Benefits Collaborative Policy Statement Women s health services are preventative

More information

American Academy of Family Physicians

American Academy of Family Physicians American Academy of Family Physicians Barbara E. Stanford MD Grand Rapids Family Medicine Residency Wege Family Medicine HPV is transient in most women HPV-75% Normal ASCUS LSIL HSIL Cancer 80-90% 75%???

More information

An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN)

An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN) An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN) Linda Kelly, DNP, ANP-BC Obstetrics and Gynecology Massachusetts General Hospital Sonja and Deborah Kelly Scholar February

More information

Teaching Breast lump aspiration. Ontario College of Family Physicians Annual Scientific Assembly Drs. Christine Rivet and Christiane Kuntz

Teaching Breast lump aspiration. Ontario College of Family Physicians Annual Scientific Assembly Drs. Christine Rivet and Christiane Kuntz Teaching Breast lump aspiration Ontario College of Family Physicians Annual Scientific Assembly Drs. Christine Rivet and Christiane Kuntz Nov 25, 2011 Disclosure Dr. Christine Rivet No conflict to disclose

More information

An individual is considered an incident case only once per lifetime.

An individual is considered an incident case only once per lifetime. 1 DERM 4 MALIGNANT MELANOMA; SKIN Includes Invasive Malignant Melanoma Only; Does Not Include Secondary Melanoma; For Malignant Melanoma In-Situ, See Corresponding Case Definition Background This case

More information

Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only]

Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only] NCCT List of Procedures Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only] Bariatric Surgery - Laparoscopic Gastric Bypass DRG - 288 MS DRG - 621 Cardiac Angioplasty

More information

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA Breast Imaging Made Brief and Simple Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA What women are referred for breast imaging? Two groups of women are referred for

More information

Clinical Scenarios CODING AND BILLING 101. Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting

Clinical Scenarios CODING AND BILLING 101. Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting Clinical Scenarios CODING AND BILLING 101 Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting 1 Always remember Follow coding guidelines If you didn t write it down, it didn t happen The

More information

Errata and Technical Corrections CPT 2015 Date: December 9, 2014

Errata and Technical Corrections CPT 2015 Date: December 9, 2014 rrata and Technical Corrections CPT 2015 Date: December 9, 2014 The information that follows is sourced to either a publication errata or a technical correction by the CPT ditorial Panel. An errata (denoted

More information

CORRECT CODING INITIATIVE OB/GYN CPT CODES INTRODUCTION

CORRECT CODING INITIATIVE OB/GYN CPT CODES INTRODUCTION CORRECT CODING INITIATIVE OB/GYN CPT CODES INTRODUCTION 2015 NOTE: CMS UPDATES THE CCI QUARTERLY. FOR THE MOST RECENT VERSION, SEE DEPT. OF HEALTH ECONOMICS AND CODING WWW.ACOG.ORG CMS Correct Coding Initiative

More information

Understanding breast changes

Understanding breast changes Understanding breast changes UHN For women Read this resource to learn: Parts of your breast Types of breast changes What follow up appointments you may need Breast Imaging Department Princess Margaret

More information

CPT/HCPCS Modifiers. [Refer to WAC 182-531-1850(10) and (11)] Italics indicate additional Agency language not found in CPT.

CPT/HCPCS Modifiers. [Refer to WAC 182-531-1850(10) and (11)] Italics indicate additional Agency language not found in CPT. CPT/HCPCS Modifiers [Refer to WAC 182-531-1850(10) and (11)] Italics indicate additional Agency language not found in CPT. 22: Unusual Procedural Services: When the service(s) provided is greater than

More information

Pap smears, cytology and CCHC lab work and follow up

Pap smears, cytology and CCHC lab work and follow up Pap smears, cytology and CCHC lab work and follow up What is a Pap Smear? A Pap smear (also known as the Pap test) is a medical procedure in which a sample of cells from a woman's cervix (the end of the

More information

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Evaluation and Management of the Breast Mass Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Common Presentations of Breast Disease Breast Mass Abnormal

More information

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening. CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests

More information

Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer

Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer Version History Version Date Summary of Change/Process 0.1 09.01.11

More information

Modifiers. This modifier can be located in the following rule(s): Anesthesia Global Maternity

Modifiers. This modifier can be located in the following rule(s): Anesthesia Global Maternity The Medical Clean Claims Task force has developed this modifier grid to identify modifiers that are considered to be important in the overall adjudication of a claim from a commercial payer perspective.

More information

ASPIRATION OF PALPABLE CYST

ASPIRATION OF PALPABLE CYST CYSTS ASPIRATION OF PALPABLE CYST GALACTOCELE New lump in nursing mother-soft to firm non-tender Treatment Aspiration FAT NECROSIS Usually there is a history of trauma - MVA, surgery. The fat dies and

More information

ALGORITHM 1: PAP & HIGH-RISK HPV SCREENING GUIDELINES

ALGORITHM 1: PAP & HIGH-RISK HPV SCREENING GUIDELINES ALGORITHM 1: PAP & HIGH-RISK HPV SCREENING GUIDELINES Women under 30 years not recommended Women 30 years and older Women 30 years and older x3 consecutive screens Women 30 years and older positive and

More information

AHLA. UU. Diagnostic Imaging Services. Thomas W. Greeson Reed Smith LLP Falls Church, VA

AHLA. UU. Diagnostic Imaging Services. Thomas W. Greeson Reed Smith LLP Falls Church, VA AHLA UU. Diagnostic Imaging Services Thomas W. Greeson Reed Smith LLP Falls Church, VA Institute on Medicare and Medicaid Payment Issues March 26-28, 2014 Diagnostic Imaging Services AHLA Medicare-Medicaid

More information

Sage Screening Program The Sage Screening Program is a statewide, comprehensive breast and cervical cancer control program whose primary objective is

Sage Screening Program The Sage Screening Program is a statewide, comprehensive breast and cervical cancer control program whose primary objective is DAS (Direct Appointment Scheduling) Training Manual MINNESOTA S CANCER SCRENlNG PROGRAM Within the Minnesota Department of Health s Cancer Control Section Sage Screening Program The Sage Screening Program

More information

ALLINA HEALTH LABORATORY

ALLINA HEALTH LABORATORY Cytology DIRECTOR: TECHNICAL SPECIALIST: JACK SHELTON, MD SCOTT HORSFALL, CT (ASCP) Requisitions A properly completed requisition form must accompany each Cytology specimen submitted to Allina Health Laboratory.

More information

D. FREQUENTLY ASKED QUESTIONS

D. FREQUENTLY ASKED QUESTIONS ACR BI-RADS ATLAS D. FREQUENTLY ASKED QUESTIONS 1. Under MQSA, is it necessary to include a numeric assessment code (i.e., 0, 1, 2, 3, 4, 5, or 6) in addition to the assessment category in all mammography

More information

PREVENTIVE MEDICINE AND SCREENING POLICY

PREVENTIVE MEDICINE AND SCREENING POLICY REIMBURSEMENT POLICY PREVENTIVE MEDICINE AND SCREENING POLICY Policy Number: ADMINISTRATIVE 238.13 T0 Effective Date: January 1, 2016 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS... APPLICATION...

More information

Benign Breast Diseases

Benign Breast Diseases Benign Breast Diseases Most women have changes in their breasts during their lifetime. Many of these changes are caused by hormones. For example, your breasts may feel more lumpy or tender at different

More information

Ultrasound - Breast. What is Ultrasound Imaging of the Breast?

Ultrasound - Breast. What is Ultrasound Imaging of the Breast? Scan for mobile link. Ultrasound - Breast Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It s primarily used to help diagnose breast lumps

More information

Understanding. Cervical Changes A Health Guide for Women. National Cancer Institute U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Understanding. Cervical Changes A Health Guide for Women. National Cancer Institute U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Cancer Institute Understanding Cervical Changes A Health Guide for Women U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health This guide helped me talk with my doctor after

More information

Anesthesia Payment & Billing Information

Anesthesia Payment & Billing Information Anesthesia Payment & Billing Information Time and Points Eligible Anesthesia Procedures Defined HMO Blue Texas SM and Blue Cross and Blue Shield of Texas have determined that certain anesthesia procedures

More information

PROPERTY OF ELSEVIER SAMPLE CONTENT - NOT FINAL ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor

PROPERTY OF ELSEVIER SAMPLE CONTENT - NOT FINAL ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor 1 ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor Cervical cytology screening has significantly decreased rates of mortality from cervical cancer; however, 400 women die each year

More information

For Women Facing a Breast Biopsy

For Women Facing a Breast Biopsy For Women Facing a Breast Biopsy Mary s doctor calls to give her the results of her mammogram. The doctor says, It s not normal, and I think we need to biopsy the area in question. Mary s first thought

More information

Pre test Question 2. Emily D. Babcock, DHSc, PA C, DFAAPA CAPA Annual Conference Palm Springs, California October 4, 2013

Pre test Question 2. Emily D. Babcock, DHSc, PA C, DFAAPA CAPA Annual Conference Palm Springs, California October 4, 2013 Emily D. Babcock, DHSc, PA C, DFAAPA CAPA Annual Conference Palm Springs, California October 4, 2013 Objectives After completion of this presentation, the participant will be able to: Explain the current

More information

Breast Imaging Protocol Eastern Radiologists, Inc. Breast Imaging Network

Breast Imaging Protocol Eastern Radiologists, Inc. Breast Imaging Network Breast Imaging Protocol Eastern Radiologists, Inc. Breast Imaging Network Screening Mammography Images: Routine CC and MLO views, XCCL if needed. Implant Patients: CC and MLO in both routine and implant

More information

Biomedical Engineering for Global Health. Lecture Thirteen

Biomedical Engineering for Global Health. Lecture Thirteen Biomedical Engineering for Global Health Lecture Thirteen Outline The burden of cancer How does cancer develop? Why is early detection so important? Strategies for early detection Example cancers/technologies

More information

IMPORTANT NOTICE REGARDING NEW ANESTHESIA BILLING GUIDELINES AND REIMBURSEMENT PROCEDURES. February 2010

IMPORTANT NOTICE REGARDING NEW ANESTHESIA BILLING GUIDELINES AND REIMBURSEMENT PROCEDURES. February 2010 IMPORTANT NOTICE REGARDING NEW ANESTHESIA BILLING GUIDELINES AND REIMBURSEMENT PROCEDURES February 2010 This notice will serve as an update to the November 2008 Anesthesia Billing Guidelines and Reimbursement

More information

Common Surgical Procedures Gyn/Oncology

Common Surgical Procedures Gyn/Oncology Malignancy Description Codes wrvu Comments Cervical Typical Open Cone biopsy 57520 4.11 Leep conization 57522 3.67 Colposcopy/Leep 57461 3.43 TAH +/- BSO 58150 17.31 Radical hysterectomy +/- BSO (Total,

More information

PETERSON LABORATORY SERVICES, P.A.

PETERSON LABORATORY SERVICES, P.A. TABLE OF CONTENTS ================================================= REQUISITION... 2 SPECIMEN LABELING... 2 PAP SMEAR SPECIMEN COLLECTION... 3 Patient Preparation... 3 Sample Collection... 3 Placement

More information

The ASA defines anesthesiology as the practice of medicine dealing with but not limited to:

The ASA defines anesthesiology as the practice of medicine dealing with but not limited to: 1570 Midway Pl. Menasha, WI 54952 920-720-1300 Procedure 1205- Anesthesia Lines of Business: All Purpose: This guideline describes Network Health s reimbursement of anesthesia services. Procedure: Anesthesia

More information

Breast Cancer. What is breast cancer?

Breast Cancer. What is breast cancer? Scan for mobile link. Breast Cancer Breast cancer is a malignant tumor in or around breast tissue. It usually begins as a lump or calcium deposit that develops from abnormal cell growth. Most breast lumps

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

PART TWO: DIAGNOSING BREAST CANCER

PART TWO: DIAGNOSING BREAST CANCER PART TWO: DIAGNOSING BREAST CANCER What is Breast Cancer? Normal cells can turn into cancer because of genetic inheritance or repeated exposure to a cancer-related substance in the environment, such as

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

Further investigations, treatments and new technologies

Further investigations, treatments and new technologies Promoting Cervical Screening Information for Health Professionals Further investigations, treatments and new technologies Population Health Queensland Cancer Screening Services Branch Queensland Cervical

More information

Appendix E: Modifiers that affect payment

Appendix E: Modifiers that affect payment Payment Policies Appendices Appendix E: Modifiers that affect payment Note: Only modifiers that affect payment are listed in this Appendix. Refer to current CPT and HCPCS books for a complete list of modifiers,

More information

I have no disclosures

I have no disclosures Breast Imaging: Ultrasound Evaluation of Breast Masses Jennifer Kohr, MD Radiologist Virginia Mason Medical Center I have no disclosures 1 Case 1: Additional views of baseline screening mammogram finding

More information

Magnetic Resonance (MRI)-Guided Breast Biopsy

Magnetic Resonance (MRI)-Guided Breast Biopsy Scan for mobile link. Magnetic Resonance (MRI)-Guided Breast Biopsy Magnetic resonance- or MR-guided breast biopsy uses a powerful magnetic field, radio waves and a computer to help locate a breast lump

More information

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group Screening for Cancer in Light of New Guidelines and Controversies Christopher Celio, MD St. Jude Heritage Medical Group Screening Tests The 2 major objectives of a good screening program are: (1) detection

More information

Image IQ: Contralateral Breast after Cancer Diagnosis

Image IQ: Contralateral Breast after Cancer Diagnosis Image IQ [1] October 17, 2014 By Stamatia Destounis, MD, FACR [2] [3] [4] [5] Page 1 of 6 [6] [7] [8] Page 2 of 6 [9] A 50-year-old patient presented for screening mammogram. Extremely dense breast tissue

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 12/17/2011 Radiology Quiz of the Week # 51 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

Malignant Lesions. 1. Distribution of Tumor. 1.1. Unifocal Carcinoma

Malignant Lesions. 1. Distribution of Tumor. 1.1. Unifocal Carcinoma 23 Malignant Lesions 1. Distribution of Tumor 1.1. Unifocal Carcinoma Figure 23.1. A 40-year-old woman presented with a palpable mass in the periareolar region. Ultrasound core biopsy yielded invasive

More information

Breast Health Center

Breast Health Center Breast Health Center Our Breast Health Center, part of Cleveland Clinic s Comprehensive Breast Cancer Program, is committed to providing compassionate care to every woman. We have state-of-the-art treatment

More information

The following is a description of the fields that appear on the results page for the Procedure Code Search.

The following is a description of the fields that appear on the results page for the Procedure Code Search. Fee Schedule Legend Updated: 9/21/2015 The following is a description of the fields that appear on the results page for the Procedure Code Search. Procedure Code the five-character procedure code as listed

More information

Accent on Health Obgyn, PC HPV Frequently Asked Questions

Accent on Health Obgyn, PC HPV Frequently Asked Questions 1. What is HPV? 2. How do you get HPV? 3. How common is HPV? 4. What are the symptoms of HPV? 5. Can HPV be treated? 6. What is the HPV test and how is it different from a PAP test? 7. Can the HPV test

More information

Breast Cancer. Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine

Breast Cancer. Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine Breast Cancer Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine DISCLOSURE Neither I nor my spouse has any relevant financial

More information

Every Woman Counts. Step-by-Step Provider User Guide

Every Woman Counts. Step-by-Step Provider User Guide Every Woman Counts Step-by-Step Provider User Guide California Department of Health Care Services Cancer Detection and Treatment Branch and Xerox State Healthcare, LLC PROPubs 6/14 TABLE OF CONTENTS INTRODUCTION...

More information

Breast Imaging East Duarte Road Duarte, CA HOPE MED M

Breast Imaging East Duarte Road Duarte, CA HOPE  MED M Breast Imaging 1500 East Duarte Road Duarte, CA 91010-3000 800.826.HOPE www.cityofhope.org MED 8116 0607 25M Breast Imaging Benefits of Early Detection One out of eight women in the U.S. will develop breast

More information

There are two levels of modifiers: Level 1 (CPT) and Level II (CMS, also known as HCPCS).

There are two levels of modifiers: Level 1 (CPT) and Level II (CMS, also known as HCPCS). PROVIDER BILLING GUIDELINES Modifiers Modifiers are two digit or alphanumeric characters that are appended to CPT and HCPCS codes. The modifier allows the provider to indicate that a procedure was affected

More information

Ultrasound of Benign Pathology. Reni Butler, M.D. Department of Radiology and Biomedical Imaging Yale School of Medicine

Ultrasound of Benign Pathology. Reni Butler, M.D. Department of Radiology and Biomedical Imaging Yale School of Medicine Ultrasound of Benign Pathology Reni Butler, M.D. Department of Radiology and Biomedical Imaging Yale School of Medicine Ultrasound of Benign Pathology Cyst Intramammary Lymph Node Lipoma Fibroadenolipoma

More information

The American Society of Breast Surgeons Performance and Practice Guidelines for Breast Ultrasound

The American Society of Breast Surgeons Performance and Practice Guidelines for Breast Ultrasound The American Society of Breast Surgeons Performance and Practice Guidelines for Breast Ultrasound The American Society of Breast Surgeons (the Society) was formed to encourage the study of breast surgery,

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

Local Coverage Determination (LCD): Screening and Diagnostic Mammography (L29328)

Local Coverage Determination (LCD): Screening and Diagnostic Mammography (L29328) Local Coverage Determination (LCD): Screening and Diagnostic Mammography (L29328) Contractor Information Contractor Name First Coast Service Options, Inc. LCD Information Document Information LCD ID L29328

More information

CMS Limitations Guide Mammograms and Bone Density Radiology Services

CMS Limitations Guide Mammograms and Bone Density Radiology Services CMS Limitations Guide Mammograms and Bone Density Radiology Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with

More information

Prerequisites. Authorization, Notification and Referral. Limitations ANESTHESIA SERVICES

Prerequisites. Authorization, Notification and Referral. Limitations ANESTHESIA SERVICES ANESTHESIA SERVICES Policy NHP reimburses participating providers for the administration of general and regional anesthesia, and supportive services performed in conjunction with covered obstetrical, surgical,

More information

VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS

VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS ACR BI-RADS ATLAS VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS American College of Radiology 55 ACR BI-RADS ATLAS A. All Breast Imaging Modalities 1. According to the BI-RADS Atlas,

More information

Hospital Patient Price Information List

Hospital Patient Price Information List Hospital Patient Price Information List Updated January 2014 Charity Care Policy As a not-for-profit healthcare facility, Fairfield Medical Center is committed to providing medically necessary treatment

More information

Infrared Thermography Not a Useful Breast Cancer Screening Tool

Infrared Thermography Not a Useful Breast Cancer Screening Tool Contact: Jeanne-Marie Phillips Sharon Grutman HealthFlash Marketing The American Society of Breast Surgeons 203-977-3333 877-992-5470 Infrared Thermography Not a Useful Breast Cancer Screening Tool Mammography

More information