Mar 12, 2013 | Medical billing basics
1. Necessary and Integral Part of Otherwise Covered ServicesIn certain circumstances, services ordinarily considered to be routine may be covered if they are performed as a necessary and integral part of otherwise covered services, such as diagnosis and treatment of...
Mar 7, 2013 | Medical billing basics
Treatment of Subluxation of Foot Subluxations of the foot are defined as partial dislocations or displacements of joint surfaces, tendons ligaments, or muscles of the foot. Surgical or nonsurgical treatments undertaken for the sole purpose of correcting a subluxated...
Feb 21, 2013 | Medical billing basics
This expanded coverage, as established at 42 CFR 410.15, is subject to certain eligibility and other limitations that allow payment for an annual wellness visit (AWV), including personalized prevention plan services (PPPS), when performed by qualified health...
Feb 15, 2013 | Medical billing basics
Screening Pap Smears Effective, January 1, 1998, §4102 of the Balanced Budget Act (BBA) of 1997 (P.L. 105-33) amended §1861(nn) of the Act (42 USC 1395X(nn)) to include coverage every three years for a screening Pap smear or more frequent coverage for women:1. At high...
Feb 11, 2013 | Medical billing basics
Screening Colonoscopies Performed on Individuals Not Meeting the Criteria for Being at High-Risk for Developing Colorectal Cancer (Code G0121) Effective for services furnished on or after July 1, 2001, screening colonoscopies (code G0121) are covered when performed...
Feb 4, 2013 | Medical billing basics
Partial List of ICD-9-CM Codes Indicating High RiskListed below are some examples of diagnoses that meet the high risk criteria for colorectal cancer. This is not an all-inclusive list. There may be more instances of conditions which may be coded and could be at the...
