Mar 22, 2013 | Medical billing basics
Background The MIPPA authorizes a new incentive program for eligible professionals who are successful electronic prescribers (E-Prescribers) as defined by MIPPA. This new incentive program is in addition to the quality reporting incentive program authorized by...
Mar 15, 2013 | Medical billing basics
Medicare Part B covers 10 hours of initial training for a beneficiary who has been diagnosed with diabetes.Diabetes is diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria; • a fasting blood sugar greater than or equal...
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...
Jan 31, 2013 | Medical billing basics
Screening Fecal-Occult Blood Tests (FOBT) (Codes G0107 & G0328) Effective for services furnished on or after January 1, 2004, one screening FOBT (code G0107 or G0328) is covered for beneficiaries who have attained age 50, at a frequency of once every 12 months...
Jan 26, 2013 | Medical billing basics
Flu Shot CPT code list • 90655-Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use; • 90656-Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years...
