FY 2016 BCCCNP Unit Cost Reimbursement Rate Schedule
|
|
|
- Jeffrey Garrison
- 7 years ago
- Views:
Transcription
1 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) 5 Diagnostic Mammogram (Bilateral) 6 Digital Diagnostic Mammogram (Bilateral) 7 Pap test, cervical or vaginal (any reporting system), requiring interpretation by physician 8 Pap test, cervical or vaginal (any reporting system), preparation; manual screening under physician supervision 9 Pap test, cervical or vaginal (any reporting system), preparation; manual screening and rescreening under physician supervision 10 Pap test, slides, cervical or vaginal (Bethesda System); manual screening under physician supervision TC G0202 G0202-TC G TC G0206 G0206-TC G TC G0204 G0204-TC G $80.86 $45.12 $35.74 $ $95.67 $35.39 $88.08 $52.34 $35.74 $ $90.51 $35.39 $ $68.85 $44.32 $ $ $ $ $ $ $14.38 FY16 11 Pap test, slides, cervical or vaginal (Bethesda System); manual screening and rescreening under physician supervision 12 Pap test, cervical or vaginal (any reporting system), preparation; screening by automated system, under physician supervision $ $29.08 FY16 1 2/01/2016
2 Unit Cost Reimbursement Schedule Service CPT Code FY16 13 Pap test, cervical or vaginal (any reporting system), $35.87 preparation; screening by automated system and manual rescreening or review, under physician supervision 14 Screening Pap test, cervical or vaginal (any reporting G0123 $27.57 system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 15 Screening Pap test, cervical or vaginal (any reporting G0124 $32.08 system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician 16 Screening Pap test, cervical or vaginal (any reporting G0145 $35.87 system), collected in preservative fluid, automated thin layer preparation, screening by automated system and manual rescreening under physician supervision 17 HPV Typing, High-risk types $ HPV Typing, Types 16 and 18 ONLY (Code ADDED effective DOS 01/01/16) $ Consultation Visit, Breast or Cervical min $ min $ Office Visit, New Patient Full Exam min $ yo $ yr $ $ Office Visit, New Patient Partial Exam min $ min 22 Office Visit, Established Patient Full Exam min min min yo yo Office Visit, Established Patient Partial Exam min 24 Urine test; pregnancy To be billed in conjunction with colposcopy services 25 Colposcopy ** Cannot be billed with pathology 88305/88307** 26 Colposcopy with Biopsy of the Cervix and Endocervical Curettage (Colp Bx & ECC) ** Cannot be billed in conjunction with 57505** ** Cannot be billed with Level V pathology 88307** $34.40 $ min $ $ TC TC $ $94.49 $ $ FY16 $43.22 $43.22 $19.53 $19.53 FY16 2 2/01/2016
3 Unit Cost Reimbursement Schedule Service CPT Code FY $ TC $ Colposcopy with Biopsy of the Cervix (Colp w/ Bx) ** Cannot be billed in conjunction with 57505** ** Cannot be billed with Level V pathology 88307** 28 Colposcopy with Endocervical Curettage (Colp w/ ECC) ** Cannot be billed in conjunction with 57505** ** Cannot be billed with Level V pathology 88307** 29 Endocervical Curettage (not part of D & C) TC TC 30 Fine Needle Aspiration of Superficial Breast Tissue, Not Using Imaging Guidance TC 31 Fine Needle Aspiration of Superficial Breast Tissue, Using Imaging Guidance TC 32 Fine Needle Aspiration (FNA), Breast Cyst TC 33 Fine Needle Aspiration (FNA), Each Additional Cyst TC 34 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, TC and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic 35 Each additional lesion, including stereotactic (Use in conjunction with 19081) 36 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 37 Each additional lesion, including ultrasound (Use in conjunction with 19083) 38 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 39 Each additional lesion, including magnetic resonance (List separately in addition to code for TC TC TC TC TC $ $ $ $93.00 $ $71.93 $ $68.30 $ $45.36 $27.46 $22.65 $ $ $ $86.83 FY16 $ $ $ $ $ $81.79 (Use in conjunction with 19085) 34-39: Do not report in conjunction with , 76098, 76942, for same lesion $1, $ $ $ $98.21 $95.41 FY16 3 2/01/2016
4 Unit Cost Reimbursement Schedule Service CPT Code FY16 40 Breast Biopsy, Needle Core, Not Using Imaging $ Guidance TC $ Breast Biopsy, Incisional $ TC $ Breast Biopsy, Excisional $ ** Anesthesia reimbursement available TC $ Breast Biopsy, Excision of Single Lesion Identified by $ Radiological Marker TC $ ** Anesthesia reimbursement available 44 Breast Biopsy, Excision of Each Additional Lesion $ Placement of breast localization device(s) (eg, clip, percutaneous; first lesion, including mammographic 46 Each additional lesion, including mammographic (List separately in addition to code for (Use in conjunction with 19281) 47 Placement of breast localization device(s) (eg, clip, percutaneous; first lesion, including stereotactic 48 Each additional lesion, including stereotactic (Use in conjunction with 19283) 49 Placement of breast localization device(s) (eg, clip, percutaneous; first lesion, including ultrasound 50 Each additional lesion, including ultrasound (Use in conjunction with 19285) 51 Placement of breast localization device(s) (eg clip, percutaneous; first lesion, including magnetic resonance 52 Each additional lesion, including magnetic resonance (List separately in addition to code for TC TC TC TC TC TC TC TC TC $ $ $ $ $53.58 $ $ $ $53.92 $ $90.00 $ $45.65 FY16 $ $ $ $ $69.41 $66.77 (Use in conjunction with 19287) 45-52: Do not report in conjunction with , 76942, and/or for same lesion. For surgical specimen radiography, use FY16 4 2/01/2016
5 Unit Cost Reimbursement Schedule Service CPT Code FY16 53 Radiological Examination, Surgical Specimen 54 Magnetic Resonance Guidance for Needle Placement, Radiologic Supervision Interpretation 55 Breast Ultrasound, Complete exam, including axilla, UNI-Lateral BI-Lateral reporting: Provider will receive 150% of the payment for a single side (unilateral) if the code is reported with modifier -50, or modifiers RT and LT, or with two units of service. 56 Breast Ultrasound, Limited exam, including axilla, UNI-Lateral BI-Lateral reporting: Provider will receive 150% of the payment for a single side (unilateral) if the code is reported with modifier -50, or modifiers RT and LT, or with two units of service. 57 Ultrasonic Guidance/Breast Needle Biopsy, Radiologic Supervision/Interpretation TC TC (one unit) TC (2 units or -50) TC (2 line items) L TC2L L (one unit) TC (2 units or -50) TC (2 line items) L TC2L L TC $16.21 $7.98 $8.23 $ $ $76.85 $ $69.19 $37.57 $ $ $56.36 $80.07 ea. $51.90 ea. $28.18 ea. $88.11 $53.03 $35.08 $ $79.55 $52.62 $66.09 ea. $39.78 ea. $26.31 ea. $59.84 $26.21 $33.63 FY16 FY16 5 2/01/2016
6 Unit Cost Reimbursement Schedule Service CPT Code FY16 58 Surgical Pathology, Breast or Cervical Biopsy - Level IV 59 Surgical Pathology, Breast or Cervical Biopsy - Level V **Cannot bill in conjunction with 57505, 57452, 57454, or 57456** 60 Pathology consultation during surgery, first tissue block, with frozen section(s), single specimen 61 Pathology consultation during surgery, each additional tissue block, with frozen section(s) 62 Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure 63 Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for 64 Cytopathology, Evaluation of Fine Needle Aspirate to determine Specimen Adequacy 65 Cytopathology, Interpretation and Report TC TC TC TC TC TC TC TC $71.45 $32.74 $38.71 $ $ $85.13 $ $37.55 $63.80 $44.72 $13.14 $31.58 $65.79 $44.09 $21.70 $88.21 $51.99 $36.22 $55.88 $18.98 $36.90 $ $76.48 $71.68 FY16 FY16 6 2/01/2016
7 Unit Cost Reimbursement Schedule Service CPT Code FY16 66 Cytopathology, Selective Cellular Enhancement Technique with Interpretation (e.g., Liquid Based Slide Preparation Method), except Cervical or Vaginal **Cannot bill in conjunction with 88173** TC $63.25 $34.80 $ Patient Navigation G9012 $ Anesthesia Payable w/ Excisional Breast Biopsies ONLY (*19120 & *19125) a. Anesthesia services performed personally by anesthesiologist b. Medical supervision by a physician: more than four concurrent anesthesia procedures AA AD $88.74 $53.24 FY16 $ $66.95 c. Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals QK $44.37 $55.79 d. CRNA service: with medical direction by a physician QX $44.37 $55.79 e. Anesthesiologist medically directs one CRNA QY $44.37 $55.79 f. CRNA service: (supervised) without medical direction by a physician QZ $88.74 $ s are based on a flat fee. Only one unit is reimbursable as indicated on the rate schedule. FY16 7 2/01/2016
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
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
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
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.](/thumbs/25/5709828.jpg "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
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,
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
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
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-
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
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
Modifier Reference PAYMENT POLICY ID NUMBER: 10-011. Original Effective Date: 05/14/10. Revised: 05/31/12 DESCRIPTION:
Private Property of Florida Blue. This payment policy is Copyright 2012, Florida Blue. All Rights Reserved. You may not copy or use this document or disclose its contents without the express written permission
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
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
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.
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
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
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
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,
Anesthesia Guidelines
Anesthesia Guidelines Updated April 2012 Anesthesia BlueCross requires anesthesiologists and certified registered nurse anesthetists (CRNAs) to file claims using CPT anesthesia codes. We cover general
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
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
What You Need to Know About Anesthesia Filing Guidelines
What You Need to Know About Anesthesia Filing Guidelines 2015 Edition Published by Provider Relations and Education Your Partners in Outstanding Quality, Satisfaction and Service This document provides
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..
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
My Coding Connection, LLC 618-530-1196. 24 Unrelated E/M by the same physician during a postoperative period
MODIFIERS Rachel Coon, CCS-P, CPC, CPC-P, CPMA, CPC-I, CEMC, ICD-10 My Coding Connection, LLC 618-530-1196 GLOBAL PACKAGE MODIFIERS 24 Unrelated E/M by the same physician during a postoperative period
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
The BreastCare Program
The BreastCare Program BreastCare Is a Program of the Arkansas Department of Health (ADH) that Offers: Screening and diagnostic services to qualifying women at no cost Public and professional education
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
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
Reimbursement Policy. Subject: Professional Anesthesia Services
Reimbursement Policy Subject: Professional Anesthesia Services Effective Date: 01/01/15 Committee Approval Obtained: 01/01/15 Section: Anesthesia ***** The most current version of our reimbursement policies
Medicare 101: Basics of Modifier Billing. Part B Provider Outreach and Education February 26, 2014
Medicare 101: Basics of Modifier Billing Part B Provider Outreach and Education February 26, 2014 Housekeeping Tips When you called in, did you enter your attendee code? Dial-in number: 1-800-791-2345
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
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)
MODIFIERS. Original Effective Date: July 7, 2009 Revision Date: February 1 st, 2014
Original Effective Date: July 7, 2009 Revision Date: February 1 st, 2014 MODIFIERS Policy s are used to increase accuracy in recording patient encounters and compensation. A modifier provides the means
Reimbursement Policy. Policy
Reimbursement Policy Subject: Modifier Usage Effective Date: 03/14/13 Committee Approval Obtained: 09/22/14 Section: Coding These policies serve as a guide to assist you in accurate claim submissions and
ALL TEXAS MEDICAID FEE SCHEDULES ARE AVAILABLE AT THE FOLLOWING LINK: www.tmhp.com
User s Guide to SECTION FOUR Page 25 ALL TEXAS MEDICAID FEE SCHEDULES ARE AVAILABLE AT THE FOLLOWING LINK: www.tmhp.com The Texas Medicaid Fee Schedule is categorized by field descriptions. () codes are
Procedure Based Coding
Procedure Based Coding Jon K. Hathaway Objectives Review Global definition Review common modifiers Procedure plus E&M codes 2013 MSACOG Snow Meeting 1 Vacuum assisted Vaginal Delivery was first reported
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
There are four anesthesia categories as determined by CMS that affect payment of anesthesia services based on the provider rendering the services:
PROVIDER BILLING GUIDELINES Anesthesia Background Qualified medical professionals administer anesthesia to relieve pain while at the same time monitoring and controlling the patients health and vital bodily
Anesthesia Services INDIANA HEALTH COVERAGE PROGRAMS. Copyright 2016 Hewlett Packard Enterprise Development LP
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Anesthesia Services L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 1 9 P U B L I S H E D : F E B R U A R Y 25, 2 0 1 6 P O L
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
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
MEDICAL POLICY Modifier Guidelines
POLICY.........PG0011 EFFECTIVE......10/30/05 LAST REVIEW... 10/13/15 MEDICAL POLICY Modifier Guidelines GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated
ANATOMIC PATHOLOGY CODING AND BILLING
ANATOMIC PATHOLOGY CODING AND BILLING CLINICAL LAB INTERPRETATIONS Requested by Pt s physician Written report to Pt s MR Requires medical judgment Use -26 modifier Hospital standing order policies CLINICAL
Empire BlueCross BlueShield Professional Reimbursement Policy
Subject: Modifier Rules NY Policy: 0017 Effective: 02/01/2014 06/30/2014 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria
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
ANESTHESIA - Medicare
ANESTHESIA - Medicare Policy Number: UM14P0008A2 Effective Date: August 19, 2014 Last Reviewed: January 1, 2016 PAYMENT POLICY HISTORY Version DATE ACTION / DESCRIPTION Version 2 January 1, 2016 Under
Status Active. Reimbursement Policy Section: Anesthesia Services Policy Number: RP - Anesthesia - 001 Anesthesia Effective Date: June 1, 2015
Status Active Reimbursement Policy Section: Anesthesia Services Policy Number: RP - Anesthesia - 001 Anesthesia Effective Date: June 1, 2015 Anesthesia Policy Description: Definitions: This policy addresses
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
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
Table of Contents A. General Billing Information.3 B. Reimbursement Guidelines...5 C. Documentation for Anesthesia Record...9
ANESTHESIA BILLING AND REIMBURSEMENT POLICY Payment policies apply to all in-network and out-of-network providers who render services to Neighborhood Health Plan of Rhode Island subscribers covered under
Anesthesia Processing Manual
Anesthesia Processing Manual Important Information The following disclaimer is applicable to all telephone inquiries and automated communications systems (i.e., telephone and fax) to Blue Cross and Blue
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,
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
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
Modifier Reference Policy
Policy Number 2016R0111C Annual Approval Date Modifier Reference Policy 11/11/2015 Approved By Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for
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
519.2 ANESTHESIA SERVICES. Background... 2. Policy... 2. 519.2.1 Covered Services... 2. 519.2.1.1 Anesthesiologist Directed Services...
TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 519.2.1 Covered Services... 2 519.2.1.1 Anesthesiologist Directed Services... 3 519.2.1.2 Emergency Anesthesia... 4 519.2.1.3 Monitored
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
Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete 76642 limited
Radiology CPT Coding Updates for 2015 Note: This article contains coding information from the 2015 Physician's Current Procedural Terminology (CPT ) Manual. CPT is a registered trademark of the American
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
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
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
Modifier Reference Policy
Policy Number 2015R0111C Annual Approval Date Modifier Reference Policy 11/12/2014 Approved By Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for
AUTHORIZED MODIFIERS. Updated: 01/16/2015
AUTHORIZED MODIFIERS Updated: 01/16/2015 A modifier provides the means for a provider to indicate that a service or procedure was altered by a specific circumstance but not changed in its definition or
PATHOLOGY/LAB CODING ALERT
The Coding Institute AAPC CEU Approved PATHOLOGY/LAB CODING ALERT The practical monthly advisor for ethically optimizing coding, reimbursement and efficiency in pathology/lab practices Vol. 2, No. 6 (Pages
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
Cervical Cancer Screening and Management Guidelines: Changing Again, Huh?
Cervical Cancer Screening and Management Guidelines: Changing Again, Huh? Summary of 2013 recommendations from ASC (American Cancer Society), ASCCP (American Society for Colposcopy and Cervical Pathology),
Oklahoma Facts CPT. Definitions. Mohs Micrographic Surgery. What Does That Mean? Billing and Coding for Mohs Surgery
Billing and Coding for Mohs Surgery Cindy L. Wilson Dermatology Associates of Tulsa Oklahoma Facts Per square mile, Oklahoma has more tornadoes than any other place in the world. The highest wind speed
AETNA BETTER HEALTH AETNA BETTER HEALTH KIDS
AETNA BETTER HEALTH AETNA BETTER HEALTH KIDS FALL 2013 Table Of Contents Aetna Better Health Kids update... 1 Medicaid enrollment... 1 Quality is in all we do at Aetna Better Health!... 2 What you need
Medicare as a Second Language
Medicare as a Second Language Policy & Practice Issues for CRNAs Lee S. Broadston President & CEO BCS,Incorporated Michigan Association of Nurse Anesthetists October 2007 Medicare as a Second Language
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
Physician Fee Schedule BCBSRI follows CMS Physician Fee Schedule (PFS) Relative Value Units (RVU) for details relating to
Policy Coding and Guidelines EFFECTIVE DATE: 09 01 2015 POLICY LAST UPDATED: 09 02 2015 OVERVIEW This Policy provides an overview of coding and guidelines as they pertain to claims submitted to Blue Cross
Having a Breast Biopsy. A Guide for Women and Their Families
Having a Breast Biopsy A Guide for Women and Their Families Fast Facts n n Most women who have a breast biopsy do not have breast cancer. About 4 out of every 5 breast biopsies are negative for cancer.
1) There are 0 indicator edits, which are never correctly reported together;
Medical Coverage Policy Coding and Guidelines sad EFFECTIVE DATE: 11/15/2011 POLICY LAST UPDATED: 11/1/2013 OVERVIEW This Policy provides an overview of coding and guidelines as they pertain to claims
The Diagnosis of Cancer in the Pathology Laboratory
The Diagnosis of Cancer in the Pathology Laboratory Dr Edward Sheffield Christmas Select 74 Meeting, Queen s Hotel Cheltenham, 3 rd December 2014 Agenda Overview of the pathology of cancer How specimens
Oregon CO-OP Modifier Table - December 2013
Oregon CO-OP Modifier Table - December 2013 Modifier Modifier Description Pricing Functionality 22 Increased Procedural Services Modifier 22 should only be reported with procedure codes that have a global
Azienda Ospedale Annunziata Cosenza - Cosenza, Italy
- Cosenza, Italy General Information New breast cancer cases treated per year 180 Breast multidisciplinarity team members 9 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and
COST, CODING, REIMBURSEMENT. Ben DuBois, M.D. San Diego, CA www.shoulderultrasound.com
COST, CODING, REIMBURSEMENT Ben DuBois, M.D. San Diego, CA www.shoulderultrasound.com Basic Legal Issues 3 Certifying organizations (certification NOT required) American Registry of Diagnostic Medical
Modifier Usage Guide What Your Practice Needs to Know
BlueCross BlueShield of Mississippi Modifier Usage Guide What Your Practice Needs to Know Modifier 22 Usage Modifier 22 - Procedural Service The purpose of this modifier is to report services (surgical
How to Get Paid for. Today s s Agenda:
How to Get Paid for Imaging Services Performed in Surgery John Marshall CRA, RCC, RT(R), FAHRA john-marshall@smh.com Disclaimer John Marshall, his wife Adrienne and their dog Shakespeare, specifically
Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only]
![Treatment Category Inpatient Treatment Categories DRG (MS DRG) ICD9 [Hip & Knee Only]](/thumbs/27/9641615.jpg "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
Ultrasound Billing CPT Codes Summary and Notes
Ultrasound Billing CPT Codes Summary and Notes CPT codes for ultrasound examinations are considered to be complete studies unless specified as limited studies in their code definitions. A limited study
Pennsylvania Workers Compensation Billing Tutorial. Step 1: Find the Charge Classes by Zip Code
Step 1: Find the Charge Classes by Zip Code http://www.portal.state.pa.us/portal/server.pt/community/charge_classes_by_zip_co de/10428 The Pennsylvania Workers' Compensation Fee Schedule for Part B providers
Management of Abnormal PAP Smears. K Chacko, MD, FACP 2010 GIM Conference
Management of Abnormal PAP Smears K Chacko, MD, FACP 2010 GIM Conference Scope of the Problem About 7-10% 7 of PAPs will come back abnormal 3.5 to 4 million in the US each year Approximate 4000 deaths
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,
r JOHNS HOPKINS HEALTHCARE Physician Guidelines Subject: Anesthesia Processing Guidelines Lines of Business: EHP, USFHP, Priority Partners
Revision Date: 11/14/14 Last Reviewed Date: 11/14/14 Page 1 of 7 ACTION New Procedure Amending Procedure Number: Superseding Procedure Number: Repealing Procedure Number: REFERENCES: AMPT Committee ASA
Stereotactic Breast Biopsy
Scan for mobile link. Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography a specific type of breast imaging that uses low-dose x-rays to help locate a breast lump or abnormality and
Creation Date: 12/24/2008. Effective Date: 07/14/2009 Date of Revision/Review: 07/14/2009 Version #:1 Date of Next Review: 07/14/2010
Site: Fremont Rideout Health Group Laboratory Services Policy and Procedure Creation Date: 12/24/2008 Subject/Title: Collection of Specimens for Conventional & ThinPrep Pap Tests, HPV Document Owner: Rogers,
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
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
Billing & Compliance for Anesthesia Services. Charles Whitten, MD Professor and Chairman
Billing & Compliance for Anesthesia Services Charles Whitten, MD Professor and Chairman Anesthesia Billing Anesthesia is a Unique Specialty ASA* vs. CPT codes Anesthesia Specific Modifiers Time based Billing
Radiology Coding: What Your Group Needs To Know In 2016
Radiology Coding: What Your Group Needs To Know In 2016 Jennifer Bash & Deborah K. Mann Coding Documentation and Education Manager Objectives Understand CPT coding changes in 2016 NCCI edits Get up to
Current Issues in Cytology: Coding Questions, Quagmires, and Quandaries
Current Issues in Cytology: Coding Questions, Quagmires, and Quandaries Please turn off or silence your cell phones Panelists Diane Davis Davey, MD: University of Central Florida, Orlando (Moderator) Susan
SURGICAL SPECIMENS SPECIMEN LABELING
SURGICAL SPECIMENS SPECIMEN LABELING NOTE: All primary specimen containers MUST be labeled with 2 identifiers at the time of collection. Submitted slides may be labeled with a single identifier, but two
Helen Joseph Breast Care Clinic - Johannesburg, South Africa
- Johannesburg, South Africa General Information New breast cancer cases treated per year 360 Breast multidisciplinarity team members 12 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists
Patient Prep Information
Stereotactic Breast Biopsy Patient Prep Information Imaging Services Cannon Memorial Hospital Watauga Medical Center Table Weight Limits for each facility Cannon Memorial Hospital Watauga Medical Center
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
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%???
- Pisa, Italy. Azienda Ospedaliero-Universitaria Di Pisa - Ospedale S. Chiara 1/6. General Information
- Pisa, Italy General Information New breast cancer cases treated per year 500 Breast multidisciplinarity team members 18 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and