Saturday, August 14, 2010

Hepatitis Panel - Medicare CPT code 80074 with valid DX

CPT Code: 80074 Hepatitis Panel/Acute Hepatitis Panel

Frequency Limitations: After a hepatitis diagnosis has been established, only individual tests, rather than the entire panel, are needed.

74 ICD-9 Codes are associated with CPT code 80074 in this policy.


070.0 Viral hepatitis A with hepatic coma
070.1 Viral hepatitis A without hepatic coma
070.20 Viral hepatitis B with hepatic coma, acute or unspecified, without hepatitis delta
070.21 Viral hepatitis B with hepatic coma, acute or unspecified, with hepatitis delta
070.22 Viral hepatitis B with hepatic coma, chronic, without hepatitis delta
070.23 Viral hepatitis B with hepatic coma, chronic, with hepatitis delta
070.30 Viral hepatitis B without hepatic coma, acute or unspecified, without hepatitis delta
070.31 Viral hepatitis B without hepatic coma, acute or unspecified, with hepatitis delta
070.32 Viral hepatitis B without hepatic coma, chronic, without hepatitis delta
070.33 Viral hepatitis B without hepatic coma, chronic, with hepatitis delta
.... 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