Tuesday, July 27, 2010

High Risk Medication DX Codes - V58.61

High Risk Medication Codes

V58.61 Long-term (current) use of anticoagulants
V58.62 Long-term (current) use of antibiotics
V58.64 Long-term (current) use of non-steroidal anti-inflammatories (NSAID)
V58.65 Long-term (current) use of steroids
V58.66 Long-term (current) use of aspirin
V58.67 Long-term (current) use of insulin
V58.69 Long-term (current) use of high risk medications
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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