by purush167 | Jul 10, 2021 | Medicare payment basics
Medicare Allowed Amount Definition Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the medicare allowed...
by Medical Billing | May 28, 2021 | Medicare payment basics
CPT CODE and Description30075-16 [977] Biopsy of pancreas30473-00 [1005] Panendoscopy to duodenum30688-00 [1949] Endoscopic ultrasoundDOUBLE BALLOON ENTEROSCOPYDouble balloon enteroscopy (DBE) is an endoscopic technique that allows examination of the small...
by Medical Billing | Mar 15, 2021 | Medicare payment basics
MODIFIER 22-UNUSUAL PROCEDURAL SERVICES This modifier indicates that a procedure was complicated, complex, difficult, or took significantly more time than usually required by the provider to complete the procedure. Documentation should be in simple “layman...
by Medical Billing | Mar 14, 2021 | Medicare payment basics
Accountable Care Organizations (ACOs)What is an ACO?ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.The goal of coordinated care is to ensure...
by Medical Billing | Feb 28, 2021 | Medicare payment basics
Procedure Code Changes and Description• Deleted Codes* 49080 – Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); initial* 49081 – Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or...
by Medical Billing | Feb 15, 2021 | Medicare payment basics
Procedure code and Description 47560 Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy47561 with guided transhepatic cholangiography with biopsy47562 cholecystectomy47563 cholecystectomy with cholangiography47564 cholecystectomy with...
by Medical Billing | Jan 18, 2021 | Medicare payment basics
Procedure code and Description CPT 87635 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe techniqueCPT 87426 – Infectious agent...
by Medical Billing | Oct 21, 2020 | Medicare payment basics
CPT CODE and Description• 99401 – preventive medicine counseling and/or risk factor intervention/s provided to an individual (separate procedure); approximately 15 minutes• 99402 – preventive medicine counseling and/or risk factor intervention/s provided to an...
by Medical Billing | Jul 24, 2020 | Medicare payment basics
Anesthesia CPT codes and Time units 00100 ANESTHESIA PROC SALIVARY GLANDS INCLUDING BIOPSY 5 00102 ANES-PROC INVOLVING PLASTIC REPAIR CLEFT LIP 6 00103 ANESTHESIA RECONSTRUCTIVE PROCEDURES OF EYELID 5 00104 ANESTHESIA FOR ELECTROCONVULSIVE THERAPY 4 00120 ANES-PROC...
by Medical Billing | Jun 11, 2020 | Medicare payment basics
A. Policy Aetna Better Health of Louisiana implements comprehensive and robust policies to ensure alignment with Louisiana Department of Health (LDH) and to warrant that regulatory standards are met. According to the AMA CPT Manual, the HCPCS Level II Manual and our...