Friday, July 30, 2010

BILLING CPT J1950 with covered diagnosis DX

 J1950 with related ICDS

For J1950 INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG (e.g., Lupron Depot®):

174.0  MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST

174.1  MALIGNANT NEOPLASM OF CENTRAL PORTION OF FEMALE BREAST

174.2  MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF FEMALE BREAST

174.3  MALIGNANT NEOPLASM OF LOWER-INNER QUADRANT OF FEMALE BREAST

174.4  MALIGNANT NEOPLASM OF UPPER-OUTER QUADRANT OF FEMALE BREAST

174.5  MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST

174.6  MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST

174.8  MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST

174.9  MALIGNANT NEOPLASM OF BREAST (FEMALE) UNSPECIFIED SITE

175.0  MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF MALE BREAST

175.9  MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST

218.0  SUBMUCOUS LEIOMYOMA OF UTERUS

218.1  INTRAMURAL LEIOMYOMA OF UTERUS

218.2  SUBSEROUS LEIOMYOMA OF UTERUS

218.9  LEIOMYOMA OF UTERUS UNSPECIFIED

259.1  PRECOCIOUS SEXUAL DEVELOPMENT AND PUBERTY NOT ELSEWHERE CLASSIFIED

617.0  ENDOMETRIOSIS OF UTERUS

617.1  ENDOMETRIOSIS OF OVARY

617.2  ENDOMETRIOSIS OF FALLOPIAN TUBE

617.3  ENDOMETRIOSIS OF PELVIC PERITONEUM

617.4  ENDOMETRIOSIS OF RECTOVAGINAL SEPTUM AND VAGINA

617.5  ENDOMETRIOSIS OF INTESTINE

617.6  ENDOMETRIOSIS IN SCAR OF SKIN

617.8  ENDOMETRIOSIS OF OTHER SPECIFIED SITES

617.9  ENDOMETRIOSIS SITE UNSPECIFIED

V10.3  PERSONAL HISTORY OF MALIGNANT NEOPLASM OF BREAST
Labels: , ,

0 comments:

Post a Comment

Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download