Sunday, August 29, 2010

Medicare CPT 82947 and covered ICD 9

CPT Code: 82947 Blood Glucose Testing 

Frequency Limitations: In stable, non-hospitalized patients who are unable or unwilling to do home glucose monitoring, it may be reasonable and necessary to measure quantitative blood glucose up to 4 times annually. 

Depending on the age and condition of the patient, the type of diabetes, degree of control, and other co-morbid conditions, more frequent testing may be reasonable and necessary.

ICD-9 Codes are associated with CPT code 82947 in this policy.


011.00 Tuberculosis of lung, infiltrative, unspecified
011.01 Tuberculosis of lung, infiltrative, bacteriological or histological examination not done
011.02 Tuberculosis of lung, infiltrative, bacteriological or histological examination unknown (at present)
011.03 Tuberculosis of lung, infiltrative, tubercle bacilli found (in sputum) by microscopy
011.04 Tuberculosis of lung, infiltrative, tubercle bacilli not found (in sputum) by microscopy, but found by bacterial culture
011.05 Tuberculosis of lung, infiltrative, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically
011.06 Tuberculosis of lung, infiltrative, tubercle bacilli not found by bacteriological or histological examination, but tuberculosis confirmed by other methods
011.10 Tuberculosis of lung, nodular, unspecified
011.11 Tuberculosis of lung, nodular, bacteriological or histological examination not done
011.12 Tuberculosis of lung, nodular, bacteriological or histological examination unknown (at present)
.... 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