|Possible Procedure/HCPCS Codes||Coverage||Patient Criteria||Patient Financial Responsibility||Provider Criteria||Possible Diagnosis Codes|
|Screening Pelvis Examination|
|G0101||Every 2 years||Not high risk||20 % allowable No Part B deductible||None stated||V76.2, V76.47, V76.49, V72.31|
|Collection of Pap Smear Specimen|
|Q0091||Every 2 years||Not high risk||20 % allowable No Part B deductible||None stated||V76.2, V76.47, V76.49, V72.31|
|82270 G0328||Annually||>50 years old||None||None stated||V76.51, V76.41|
|77057, +77052 G0202||Annually||>40 years old||20 % allowable No Part B deductible||None stated||V76.12, V76.11|
|Screening Bone Mass Measurement|
|77078, 77079, 77080, 77081, 77083, 76977, G0130||Once every 24 months||Patients at risk||20% allowable Deductible applies||Test ordered by physician or qualifed non physician practitioner who is treating patient.||Determined by Local Carriers*|
|Initial Preventive Physical Examination (Welcome to Medicare Examination)|
|G0402, G0403, G0404, G0405||Once||Within first 12 months of Medicare coverage||20% allowable Deductible waived, but co-insurance provision apply||Test ordered by physician or qualifed non physician practitioner who is treating patient.||V070.0|
|82947, 82950, 82951||Twice in 12 month period||Patients at risk||None||None stated||V77.1|
|Cardiovascular Screening Blood Test|
|82465, 84478, 83718, 80061||Every 5 years||All Medicare beneficiaries||None||Test must be ordered by physician and used in management of patient||V81.0, V81.1, V81.2|
|Tobacco Use Cessation Counseling|
|99406, 99407||2 cessation attempts in 12 month period (1 attempt=up to 4 sessions)||Patient has condition or is receiving treatment that is being adversely affected by tobacco use||20% allowable Deductible applies||Provided by a physician, physician assistant, nurse practitioner, clinical nurse specialist, qualified psychologist or clinical social worker||Use code indicating patient's condition or treatment affected by tobacco use|
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
Know Medicare screening services fully - CPT and covered DX
Summary of Medicare Screening Services
Labels: Medicare screening
Top Medicare billing tips
URIBEL- methenamine, sodium phosphate, monobasic, monohydrate, phenyls alicylate, methylene blue, and hyoscyamine sulfate capsule Uribel i...
procedure code and description 71250 - Ct thorax w/o dye - average fee payment - $180 - $190 71275 CTA chest (noncoronary) 71260 CT ...
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 ...
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
PR 1 Deductible Amount PR 2 Coinsurance Amount PR 3 Co-payment Amount OA 4 The procedure code is inconsistent with the modifier used ...
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...