Mar 19, 2011 | Medical billing basics
GLOBAL SURGERY MODIFIERS Use the following modifiers pertaining to global surgery: Modifier 24 24 Modifier Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Physician may need to indicate that an evaluation and management...
Mar 19, 2011 | Medical billing basics
INDICATIONS AND LIMITATIONS OF COVERAGE AND/OR MEDICAL NECESSITY For the purpose of Medicare, subluxation means a motion segment in which alignment, movement integrity and/or physiological function of the spine are altered although contact between joint surfaces...
Mar 18, 2011 | Medical billing basics
NECESSITY FOR TREATMENT A. The patient must have a significant health problem in the form of a neuromusculoskeletal condition necessitating treatment, and the manipulative services rendered must have a direct therapeutic relationship to the patient’s condition and...
Mar 18, 2011 | Medical billing basics
ICD-9-CM Codes That Support Medical Necessity The CPT/HCPCS codes included in this LCD will be subjected to “procedure to diagnosis” editing. The following lists include only those diagnoses for which the identified CPT/HCPCS procedures are covered. If a covered...
Mar 18, 2011 | Medical billing basics
CPT Code Description 98940 Chiropractic manipulative treatment (CMT); spinal, 1-2 regions 98941 Chiropractic manipulative treatment (CMT); spinal, 3-4 regions 98942 Chiropractic manipulative treatment (CMT); spinal, 5 regions 98943 Chiropractic manipulative treatment...
Mar 18, 2011 | Medical billing basics
HCPCS Codes Effective for claims with dates of service on June 30, 2011, Medicare providers shall report one of the following HCPCS codes for PROVENGE®: • C9273 – Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including...
