Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain
Oct27

Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain

Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain In June 8, 2012, CMS issued a Medicare National Coverage Determination (NCD) that allows coverage of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic low back pain (CLBP) only when the patient is enrolled in an approved clinical study within three years after the June 8, 2015 under coverage with evidence development (CED) that meets the criteria outlined below. It only allows coverage for TENS use in the treatment of Chronic Low Back Pain (CLBP) only under specific conditions which are described in the NCD Manual, Pub. 100-03, chapter 1 Section 160.27. Read More about the Decision Memo for a Complete Guideline – CLICK HERE! Searched Keywords: Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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HCFA 1500 CMS Place of Service Codes Guidelines | Box 24 B POS
Oct24

HCFA 1500 CMS Place of Service Codes Guidelines | Box 24 B POS

HCFA 1500 CMS Place of Service Codes Guidelines Listed below are place of service codes and descriptions. These codes should be used on your professional claims see Box 24B on HCFA 1500 CMS Place of Service: 01 Pharmacy A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients. (effective 10/1/05) 2005-10-01 02 Unassigned N/A 03 School A facility whose primary purpose is education. 2003-01-01 04 Homeless Shelter A facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family shelters). Special Considerations Note that for the purposes of receiving durable medical equipment (DME), a homeless shelter is considered the beneficiary’s home. Because DME is payable in the beneficiary’s home, the crosswalk for Homeless Shelter (code 04) to Office (code 11) that was mandated effective January 1, 2003, may need to be adjusted or local policy developed so that HCPCS codes for DME are covered when other conditions are met and the beneficiary is in a homeless shelter. If desired, local contractors are permitted to work with their medical directors to determine a new crosswalk such as from Homeless Shelter (code 04) to Home (code 12) or Custodial Care Facility (code 33) for DME provided in a homeless shelter setting. If a local contractor is currently paying claims correctly, however, it is not necessary to change the current crosswalk. 2003-01-01 05 Indian Health Service Free-standing Facility A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization. (See 05-08 Special Considerations below.) 2003-01-01 06 Indian Health Service Provider-based Facility A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients. (See 05-08 Special Considerations below.) 2003-01-01 07 Tribal 638 Free-standing Facility A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to tribal members who do not require hospitalization. (See 05-08 Special Considerations below.) 2003-01-01 08 Tribal 638 Provider-based Facility A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to tribal members admitted as inpatients or outpatients. (See 05-08...

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Neurology Medical Codes for Billing | Analysis and Programming CPT Codes
Oct20

Neurology Medical Codes for Billing | Analysis and Programming CPT Codes

Neurology Medical Codes for Billing and Analysis and Programming CPT Codes   Neurology CPT Code 95970 Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/ transmitter, without reprogramming Neurology CPT Code  95971 (3 or fewer parameter changes) Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming Neurology CPT Code 95974 (More than 3 parameter changes) Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour Neurology CPT Code 95975 Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, each additional 30 minutes after first hour (List separately in addition to code for primary procedure.) Epilepsy ICD-10 Neurology Codes Cross Over ICD 10 Code G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus ICD 10 Code G40.219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus ICD 10 Code G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus ICD 10 Code G40.111 (Attacks without alteration of conscious) Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus ICD 10 Code G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus ICD 10 Code G40.119 (Attacks without alteration of conscious) Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus Got Questions? on Physician Billing, Coding and Credentialing?  Please call us today.   Search keywords: Neurology Medical Codes Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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2017 New Physical Therapy Evaluation Codes – Final Rule
Oct14

2017 New Physical Therapy Evaluation Codes – Final Rule

Here comes 2017 and we have 3 New Physical Therapy Evaluation Codes. CMS has proposed a new physical therapy codes for 2017 as part of the Medicare Physician Fee Schedule (CMS-1654-P) proposed rule for 2017 . We have now the: 2017 New Physical Therapy Evaluation Codes Key Points: Each of these codes are not “time-based”; typical time is used as a guidance only Complexity (low-medium-high) Therapy Evaluation encounter MUST meet Medical Necessity and clearly documents FUNCTION Use these new therapy evaluation codes for Medicare and commercial payers; Workers’ Comp and MVA liability may still be using 97001/97002 CPT Code 97001 is DELETED and REPLACED by 3 new physical therapy evaluation Codes CPT Code 97002 is DELETED and REPLACED by one single re-evaluation code These New Physical Therapy Evaluation Codes has 4 Components of Complexity and Severity: Patient Medical and Functional HISTORY, which includes relevant comorbities and personal factors; Comorbities/pre existing conditions that affects function and ability to progress through a plan of care History of Functional limitation(s) and level; current functional level, abilities and limitations Identify and Document Personal Factors that may impact the plan of care for Physical Therapy treatment; eg. age, gender, social history, education background, lifestyle, coping styles, job/profession, present/past experience. Document the overall behavior patterns including experience with disability Existing personal factors that will not impact the plan of care should not be used when selecting the level of service Examination of body system(s) using standardized tests and measures; Body Structures: Anatomical or structural parts of the body, eg., the organs, limbs and their components, classified according to the body systems; Body Regions: Includes the Head, neck, back, lower extremities, upper extremities and trunk Body Systems: Musculoskeletal (range of motions, strength, weight/height, symmetry) Neuromuscular (coordinated physical/body movement which includes gait transfers, locomotion and transitions) and motor functions on control and learning Cardiovascular Pulmonary (RR, HR, BP and Edema) Integumentary (skin integrity, texture, presence of scar formation) Review of Systems should also include orientation of person, place and time; consciousness, the ability to express/show needs, anticipated emotional and or behahavioral responses Clinical Presentation of the patient Stable and uncomplicated, OR Evolving clinical presentation with changing clinical characteristics OR Evolving clinical presentation with unstable and unpredictable characteristics Clinical Decision Making (based including the utilization of standardized patient assessment tools and or using the Functional Outcome measurable assessment result The codes are based in large part on the amount of time and complexity involved in the evaluation. See below identifies the new physical therapy codes for 2017 and gives the long-form description of each code. 2017 New Physical Therapy Evaluation Codes  CPT Code 97161 Physical therapy evaluation: low complexity, requiring these components: A history...

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CPT Code for Urine Drug Screen | Pain Management Clinic Drug Testing
Oct14

CPT Code for Urine Drug Screen | Pain Management Clinic Drug Testing

  *** 2017 NEW CPT CODES FOR URINE DRUG SCREENING – READ AND CLICK HERE! CPT Code for Urine Drug Screen | Pain Management Clinic Drug Testing G0431 (DELETED December 2015) G0434 (DELETED December 2015) New Codes: January 2016 CPT Code for Urine Drug Screen Presumptive CPT Code for Drug Screen Testing G0477 QW Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg, immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0478 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg, immunoassay) read by instrument-assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0479 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg, immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service. Definitive CPT Code for Drug Screen Testing G0480 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (eg, IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 1-7 drug class(es), including metabolite(s) if performed. G0481 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (eg, IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 8-14 drug class(es), including metabolite(s) if performed. G0482 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (eg, IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 15-21 drug class(es), including metabolite(s) if performed.) G0483 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding...

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