Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Medicare Changes to 2010 CPT Inpatient Consultation Codes
Prevent 99251-99245 denials in 2010 with this checklist.
Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do.
Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles E. Haley, MD, MS, FACP, Medicare medical director for Trailblazer Health Enterprises, LLC, told the audience during the E/M session at the 2010 CPT symposium. “If come January you’re getting denials, work out the issues with your specific contractor.”
You can, however, prevent many rejections from Medicare’s invalidation of 99251-99245 by following this checklist.
√ Use Initial Hospital Day Codes on Day 1
If a physician consults a patient on his first day in the hospital, you should use an initial hospital code (99221-99223), according to Medicare’s new consultation guidelines for 2010. “Stop thinking of these codes as admit codes,” cautioned Peter A. Hollmann, MD, the AMA CPT Editorial Panel, Vice Chair. They are for initial hospital care. “We should say ‘admitting physician’ when we mean just that.
More than one physician can use an initial hospital care code for the same patient. If two physicians from different specialties are both consulting on a patient, both physicians use the initial code. Next, what’s up with modifier AI?
√ Designate Admitter With Modifier
Surgery coders will have to educate primary care physicians who perform the majority of admissions on attaching an appendage to indicate his role as the admitting doctor. “The physician of record will use the initial code with a modifier,” stressed Kenneth B. Simon, MD, MBA, CMS senior medical officer, in “Medicare Physician Payment Schedule 2010 Changes and Beyond” at the AMA CPT and RBRVS 2010 Annual Symposium in Chicago. All other same...
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
Billing J code examples cpt code and description J0702 - Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg ...
PR 1 Deductible Amount PR 2 Coinsurance Amount PR 3 Co-payment Amount OA 4 The procedure code is inconsistent with the modifier used ...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
Procedure code and description 93224 - External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage;...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
Drugs & Biologicals: Maximum Allowed Units (MAUs) - Palmetto GBA Medicare cpt code and description J1040 - Injection, methylpredniso...
All Service Codes for Immunization/Vaccine 86615 (CPT) - Antibody; Bordetella 86619 (CPT) - Antibody; Borrelia (relapsing fever) 8...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Procedure Code Description 70370 Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique 70...