Nov 9, 2010 | Medical billing basics
Benefits and Limitations This section describes program-specific benefits and limitations. Refer to Chapter 3, Verifying Recipient Eligibility, for general benefit information and limitations. Medicaid covers maintenance dialysis treatments when they are provided by a...
Nov 2, 2010 | Medical billing basics
Professional and Technical Components Some procedure codes in the 70000, 80000, 90000, and G series are a combination of a professional component and a technical component. Therefore, these codes may be billed one of three different ways; (1) as a global, (2) as a...
Nov 2, 2010 | Medical billing basics
Global Surgical Packages Effective for dates of adjudication 10/1/06 and thereafter, Medicaid will adopt Medicare’s RVU file designation for global surgical days. In the past and through date of adjudication September 30, 2006, Medicaid has used a 62 day post op...
Nov 1, 2010 | Medical billing basics
Renal Dialysis Facility End Stage Renal Disease (ESRD) services are outpatient maintenance services provided by a freestanding ESRD facility or hospital-based renal dialysis center National Provider Identifier, Type, and Specialty A provider who contracts with Alabama...
Nov 1, 2010 | Medical billing basics
Repeat Lab Procedures – Medicaid Modifier 91 may be utilized to denote a repeat clinical laboratory test performed on the dame date of service for the same recipient. Providers should use modifier 91 instead of modifier 76 for repeat lab procedures A physician...
Oct 28, 2010 | Medical billing basics
Lab Tests Performed in Physician’s Offices When performing laboratory tests in the physician’s office: 1. The Physician must be CLIA certified to perform the test, 2. The Physician must have the appropriate equipment to perform the test, and 3. The Physician’s office...
