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Medicare allowed amount, Maximum allowable

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...

CPT 30075, 30473, 30688 – Panendoscopy

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...

Modifier 22 – Unusual increased procedural services – tips and reimbursement guidelines

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...
Medicare ACO – Accountable care Organizations – All the update and Guideline

Medicare ACO – Accountable care Organizations – All the update and Guideline

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...

CPT code 49082, 49083, 49084 – abdominal paracentesis

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...

CPT 47560, 47561, 47562, 47563, 47564, 47570 and 47579

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...

CPT code 87635, 87426, 87428, 87811

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...

CPT 99401, 99402, g0446, g0447 and G0473

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...

Most used Anesthesia CPT codes and time units

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...

Finger Modifier Guidelines and usage examples

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...
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CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). All Rights Reserved to AMA.
The revenue codes and UB-04 codes are the IP of the American Hospital Association. All Rights Reserved to AMA.
All our content are education purpose only. All the articles are getting from various resources. If you find anything not as per policy. Please reach out and we would do the investigation and remove the article.
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