Sunday, August 29, 2010

billing CPT 82728 & covered DX

CPT Code: 82728 Serum Iron Studies 

Frequency Limitations: If a normal serum ferritin level is documented, repeat testing would not ordinarily be medically necessary unless there is a change in the patient's condition, and ferritin assessment is needed for the ongoing management of the patient. 

When an End Stage Renal Disease (ESRD) patient is tested for ferritin, testing more frequently than every three months (the frequency authorized by 3167.3, Fiscal Intermediary manual) requires documentation of medical necessity [e.g., other than Chronic Renal Failure (ICD-9-CM 585) or Renal Failure, Unspecified (ICD-9-CM 586)].


ICD-9 Codes are associated with CPT code 82728 in this policy.


002.0 Typhoid fever
002.1 Paratyphoid fever A
002.2 Paratyphoid fever B
002.3 Paratyphoid fever C
002.9 Paratyphoid fever, unspecified
003.0 Salmonella gastroenteritis
003.1 Salmonella septicemia
003.20 Localized salmonella infection, unspecified
003.21 Salmonella meningitis
003.22 Salmonella pneumonia
.... and many more.
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