Thursday, August 26, 2010

billing CPT 82523 and covered DX

CPT Code: 82523 Collagen Crosslinks, Any Method

Frequency Limitations: Current recommendations for appropriate utilization include: one or two base-line assays from specified urine collections on separate days; followed by a repeat assay about three months after starting anti-resorptive therapy; followed by a repeat assay in 12 months after the three-month assay; and thereafter not more than annually, unless there is a change in therapy in which circumstance an additional test may be indicated three months after the initiation of new therapy.

ICD-9 Codes are associated with CPT code 82523 in this policy.


242.00 Toxic diffuse goiter without thyrotoxic crisis or storm
242.01 Toxic diffuse goiter with thyrotoxic crisis or storm
242.10 Toxic uninodular goiter without thyrotoxic crisis or storm
242.11 Toxic uninodular goiter with thyrotoxic crisis or storm
242.20 Toxic multinodular goiter without thyrotoxic crisis or storm
242.21 Toxic multinodular goiter with thyrotoxic crisis or storm
242.30 Toxic nodular goiter, unspecified, without thyrotoxic crisis or storm
242.31 Toxic nodular goiter, unspecified, with thyrotoxic crisis or storm
242.40 Thyrotoxicosis from ectopic thyroid nodule without thyrotoxic crisis or storm
242.41 Thyrotoxicosis from ectopic thyroid nodule with thyrotoxic crisis or storm
.... and many more.  
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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