In Billing
May 11th, 2017
Recognizing the U.S. Preventive Services Task Force’s updated recommendations for hepatitis B virus (HBV) screening, Medicare has added Part A and Part B coverage for HBV screening, effective Sept. 28, 2016. Naturally, there are conditions for coverage. Conditions for Coverage The screening must be performed using the appropriate FDA-approved laboratory test, used consistent with FDA-approved...
In CMS
May 8th, 2017
The 2017 CPT® codebook introduced three new codes to describe mammography services. Unlike the codes they replaced (77051, 77052, 77055, 77056, and 77057), the new codes specifically include computer-assisted detection (CAD), when performed: 77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral 77066 Diagnostic mammography, including computer-aided detect...
In Coding
May 8th, 2017
Modifiers GT Via interactive audio and video telecommunications systems and GQ Via an asynchronous telecommunications system apply only when reporting telehealth services. Centers for Medicare & Medicaid Services (CMS) rules stipulate that as a condition of payment for telehealth services, providers “…must use an interactive audio and video telecommunications system that permits real-time commu...
In Coding
May 5th, 2017
AMA’s Instructions for Use of the CPT® Codebook tell us, “do not select a CPT code that merely approximates the service provided. If no such specific code exists, then report the service using he appropriate unlisted procedure or service code.” The Instructions further note, “Each of these unlisted procedural code numbers (with the appropriate accompanying ...
In CMS
May 5th, 2017
For Medicare beneficiaries in the office setting, if a provider preps a patient for a screening colonoscopy but cannot advance the scope past the splenic flexure due to obstruction, patient discomfort, or other complications, append modifier 53 Discontinued services to the appropriate code, per CMS Program Memorandum Transmittal AB-03-114, Change Request 2822. The Transmittal stresses, ...