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
Billing consult code and preventive code together
Consult and Preventive codes
A consultation is an evaluation of a patient provided by a physician at the request of another physician or appropriate source. The consulting physician may order tests or therapeutic services at the time of the visit, and these would be reported separately. The request for the consultation as well as the consultant's opinion must be documented in the patient's chart. A written report must be sent back to the physician requesting the consult. A consultation requested by the patient or family member and not by a physician or appropriate source should not be reported with consultation codes. Report the appropriate evaluation and management (E/M) code for this service.
If an abnormality/ies is encountered or a preexisting problem is addressed in the process of performing this preventive medicine evaluation and management service, and if the problem/abnormality is significant enough to require additional work to perform the key components of a problem-oriented E/M service, then the appropriate office/outpatient code 99201-99215 should also be reported. Modifier -25 should be added to the office/outpatient code to indicate that a significant, separately identifiable evaluation and management service was provided by the same physician on the same day as the preventive medicine service. The appropriate preventive medicine service is additionally reported.
A problem/abnormality encountered in the process of performing the preventive medicine evaluation and management service that does not require additional work and the performance of the key components of a problem-oriented E/M service should not be reported.
Labels: Medicare basic concept
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...