Posts tagged: 2013

list of behavioral health cpt modifiers 2013

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By , April 4, 2016 1:51 pm

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list of behavioral health cpt modifiers 2013

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2016 Provider Reimbursement Manual – MDwise

Jan 1, 2014 … BHS – Behavioral Health Services . ….. We have included applicable CPT and
ICD-10 codes for you to reference. Please note … In addition to the diagnosis/
procedure list below, use of G7 modifier (the pregnancy resulted from.

A GUIDE TO PROCEDURE CODES CLAIMING MENTAL HEALTH …

Mar 16, 2015 … County of Los Angeles – Department of Mental Health … List of Abbreviations …
…. (CPT) codes and the Level II Health Care Procedure Coding System …. For
Contract providers submitting electronic claims, the SC modifier …

Medicaid Provider Manual – Department of Human Services

Michigan Department of Health and Human Services. Medicaid Provider Manual
… Date: January 1, 2016. Page 1. MEDICAID …. Mental Health and Substance ….
Acronym Appendix for a list of all those used in the manual.) Start the search on …

Network Update – Anthem

Dec 31, 2014 … Behavioral health update … Applied behavior analysis (ABA) CPT codes … There
will be no modifier override unless diagnosis criteria described above is …. 2014,
as scheduled, beginning July 1, 2015 through June 30, 2016. ….. A complete list
of precertification requirements can be found at the Provider …

BCN Provider MAnual – Chapter 13 Behavioral Health – e-Referral

Contents. Behavioral Health. 2016. Behavioral Health. BCN Provider Manual.
Contents …. listings are included in CPT. The AMA assumes …. This list is
available at ereferrals.bcbsm.com > Quick Guides > BCN · Provider …. *CPT
codes, descriptions and two-digit numeric modifiers only are copyright 2015
American. Medical …

TELEMEDICINE POLICY – Oxford Health Plans

Jan 1, 2016 … Telemedicine Policy: Reimbursement Policy (Effective 01/01/2016) …. (CP) and
clinical social workers (CSW) cannot bill for psychiatric … For a complete list of
codes that Oxford recognizes when reported with modifier GT refer to: … Oxford
follows CMS guidelines and does not reimburse for CPT codes …

Home Health Medicare Billing Codes Sheet – CGS

Home Health Medicare Billing Codes Sheet. H-008-09 • Page … 65 Discharge/
transfer to psychiatric hospital or psychiatric … institution not defined elsewhere in
code list … See CPT coding book for appropriate. HCPCS … For episodes
beginning on/after 7/1/2013, … NOTE: Not valid for visits made on or after 1/1/
2016. 055X.

Professional Provider Office Manual – BCBSLA – Blue Cross and …

Blue Shield Association and incorporated as Louisiana Health Service &
Indemnity … Modifiers. 40. Equipment, Devices and Supplies. 46. Code Editing:
Billing Practices … Behavioral Health …. Terminology (CPT®) codes and ICD-10-
CM diagnosis codes. ….. Select the “Provider Update Form” form from the list and
fill in the.

March 2013 – Aetna

Mar 3, 2013 … Changes to the National Precertification List (NPL) … Health Insurance
Exchanges are coming – learn more about them … to buy individual insurance by
2016, you can … including diagnosis codes, modifiers and place of service to ….
The CPT codes for a ….. origin, religion, sex, age, mental or physical.

Obstetrical Services Policy (R0064) – UHCCommunityPlan.com

Mar 11, 2015 … 2016R0064A … This reimbursement policy applies to all health care services
billed on CMS …. appending modifier 22 to the global OB code (CPT codes
59400 and 59610) or ….. condition, physician and mental effort required). ….. A
list of ICD-9 diagnosis codes related to obstetrics to be used on or before.

Fact Sheet on the Resource Based Relative Value Scale (RBRVS …

Feb 2, 2014 … 2013), the Division updated the workers' compensation Physician Fee Schedule
… uses the Medicare 2014 relative value units and 2014 CPT … The pre-2014
OMFS set one RVU for each procedure, and did not list separate RVUs ….. Only
psychiatrists are eligible for the Mental Health HPSA, and if the …

Medicaid Update March 2015 – Department of Health – New York State

Mar 11, 2015 … The NY Medicaid Electronic Health Record (EHR) Incentive …. modifier helps to
avoid duplicate discounts on 340B Medicaid claims. … new PET scan fees
effective April 1, and the CPT billing codes for tracers: … SPARCS surgical
volumes to revise the list of low-volume hospitals …… The January 1, 2016.

Prescription Drug Program Billing Instruction – Health Care Authority

Jan 1, 2016 … This publication takes effect January 1, 2016, and supersedes … modifiers. …
CPT, and the AMA is not recommending their use. ….. Mental health
polypharmacy. …. Is there a list of drugs that do not require authorization?

greater new orleans community health connection provider manual

May 19, 2014 … Serious Mental Illness Behavioral Health Care Services …. accordance with
section 1923 of the Social Security Act. In September 2013, CMS approved a …
demonstration waiver to December 31, 2016 and the removal of the requirement
to be …. See Appendix E for applicable HCPCS and CPT codes.

2016 OPPS Proposed Rule Summary

Jul 1, 2015 … CMS has proposed to increase CY 2016 OPPS payments by 1.9 percent. ….
HCPCS modifier to report adjunctive services that are billed on a different claim
from … Mental health services (Composite APC 0034); and ….. credit offset policy
would apply is the list of Device-‐Intensive APCs found in Table 38 …

Physician Quality Reporting System (PQRS) – SETexasRHP.com

Apr 9, 2015 … for Behavioral Health Providers. Network of … Reporting Behavioral Measures …
Negative Adjustment. Rate. 2013. 2015. -1.5%*. 2014. 2016. -2.0%*. 2015 … A
list of eligible medical care professionals is available on the How to Get …. Use of
Current Procedural Terminology (CPT) Category I Modifiers.

CY 2014 Medicare Outpatient Prospective Payment System … – AAMC

Nov 1, 2015 … Community Mental Health Centers (CMHCs) … Claims-based approach (HCPCS
modifier). • Break out costs …. procedures from the inpatient list for CY 2014. 17.
Source: …. level data is submitted directly to CMS for CY 2016.

Using Medicare PQRS 2014 Individual Measures in Clinical Practice

percent penalty in 2016 for not using measures in … providing psychotherapy
services to Medicare … the list provided above that best describes … Exclusion
Modifiers and 8P reporting modifier. … Terminology (CPT) Codes must be used
with.

FEB 2015 | Network Bulletin – CAAP

Feb 16, 2015 … UnitedHealthcare respects the expertise of the physicians, health care …
Preauthorization List Additions for UnitedHealthcare … adopt the CMS process
for modifier 78 for Medicare … The 2015-2016 Credentialing Plan and State and
… the new CPT codes for IMRT services (G6015, ….. Behavioral analyst.

Telemedicine Task Force – Interim Report – MHCC – Maryland.gov

May 2, 2013 … are not using the modifier in claims submission. 6 The Maryland Department of
Health and Mental Hygiene's Medical … Senate Bill 776 (2013), Telemedicine
Task Force – Maryland Health Care Commission,(SB ….. The 2013 list of
Medicare telehealth covered services is (by CPT or HCPCS codes)—.

cpt code 99214 definition 2013

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By , February 22, 2016 10:27 pm

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cpt code 99214 definition 2013

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Telemedicine Policy (R0046) – UHCCommunityPlan.com

Apr 8, 2015 … 2016R0046A … This reimbursement policy applies to all health care services
billed on CMS 1500 forms and, when …. UnitedHealthcare Community Plan will
also reimburse CPT codes ….. History prior to 1/1/2013 archived.

Menopause: Definitions – Public Health Division

2013 CPT Codes for. Contraceptive … ACOG will transmit suggestions to CMS for
changes in 2016 … Interim Description HCPCS National Code Description …. E/M
established. Typical time. (min). 99211. 5. 99212. 10. 99213. 15. 99214. 25.

2014 PQRS Individual Measure Specifications – American College …

Dec 13, 2013 … numbering from the 2013 measures. … Those who report satisfactorily for the
2014 program year may avoid the 2016 payment adjustment. … specifications
define circumstances in which a patient may be appropriately … specific CPT
Category II reporting modifier 8P or quality-data code may be used to …

Implementing a RB-RVS Fee Schedule for Physician Services

Jun 1, 2013 … Using Medicare policies to establish the fee schedule amounts, aggregate
allowances will ….. Appendix C OMFS Codes with No 2013 CPT Equivalent
Codes. …. Table 6.6 Comparison of Allowances for CPT 99214 under Current
OMFS ….. 2016. 25/75. Blend adjusted for inflation. 2017. 120 %. Medicare.

Procedure code Description Medicaid fee 2013 … – Med-QUEST

Medicaid Fee Schedule without mods effective 01/01/2013. Note: Any procedure
code with payment of $0.00 is a non-covered service. Procedure code.

Effective Coding Practices in Reproductive Health Care

Aug 4, 2014 … 99214. Detailed. Can't tell without more information. Don't know. What Is the
Fundamental … 2013 CPT Codes for. Contraceptive Procedures. CPT.
Description …. ACOG will transmit suggestions to CMS for changes in 2016.

Final 2013 Medicare Physician Fee Schedule – Physicians Inpatient …

Earlier this year, CMS released the proposed 2013 Medicare Physician Fee
Schedule on May ….. The clinical labor practice expense inputs for CPT 99214 (
Level 4 … In 2013, CMS will pay for new CPT TCM codes 99495 and 99496 with
some small …. in 2014, the payment penalty would be 2 percent in 2016 and
beyond.

June 2015 Network Update – Anthem

Jun 27, 2015 … o Reimbursement limitations for CPT codes 99214 and 99215 25 … This is to
inform you that effective January 1, 2016, Anthem will be offering new …… and
Mental Health Services Administration's (SAMHSA) 2013 National.

2016 Provider Reimbursement Manual – MDwise

Jan 1, 2014 … MDwise Marketplace Reimbursement Manual ….. We have included applicable
CPT and ICD-10 codes for you to …… Effective for claims with dates of service on
and after October 1, 2013, payment for non-emergency.

Understanding Current Billing & Coding Rules & Preparing for …

Oct 1, 2015 … Reviewing Possible & Known Changes for CY 2016. Q&A. Copyright … *CPT
code 77014 was not deleted by the AMA, but they did indicate it cannot be
reported for IGRT for hospitals. For ….. 99214 Office/outpatient visit est. 3.03 ….
2013 PQRS, Medicare Shared Savings Program and Pioneer ACO Model.

CURRENT TOPICS IN RADIATION ONCOLOGY REIMBURSEMENT …

Jun 29, 2012 … to verify applicable codes and reimbursement levels. ….. CMS finalized its
decision to use CY 2013 as the … 2016 and each subsequent year: 2.0 percent
…. In 2010 the AMA replaced CPT code 77334 (treatment devices, design and …..
99214. Office/outpatient visit, est. $99.71. $95.14. $4.57. -4.58%.

update on cpt codes and alternative payment mechanisms

CPT Changes for 2016. ▻ GI … for 2016. ▻ Vaccine codes – Deletion of 17
vaccine products no …. For example, prolonged clinical staff services for 99214 …
Source: The Medicare Access and CHIP ….. Health System Strategy, 2003-2013.

MARC – MN Community Measurement

May 13, 2015 … established patients: 99211, 99212, 99213, 99214 and 99215. … Jasmine
answered that the CPT codes will be gathered from billing …. reporting years in a
row (2016 – statin definition change; 2017 – established patient criteria change).
…. In March 2013, the MARC approved the criteria for risk adjustment …

Defendant's Status Report (June 2013) – Public Interest Law Center …

Jun 24, 2013 … Medicare and Medicaid Services (CMS) approved the State Plan Amendment ….
Fiscal Years 2013-2014 through 2015-2016 includes $173.8 million in recurring
General …. Terminology (CPT) codes is available on the provider web portal and
will …. Procedure codes 99212, 99213, and 99214 do not have.

2013 Physician Fee Schedule – American Academy of Family …

Earlier this year, CMS released the proposed 2013 Medicare Physician Fee
Schedule on ….. The work RVU of CPT code 99238 (Hospital discharge day
management; … The malpractice expense RVUs for CPT 99214, which results in
a proposed ….. in 2014, the payment penalty would be 2 percent in 2016 and
beyond.

CY 2016 CPT UPDATES – ICD-10online.com

Dec 1, 2015 … XR-29-2013 standard. Modifiers. HCPC Code Set. Code. Description. G0296.
Counseling visit to discuss need for lung cancer screening (LDCT) …. 2016
forward – report the service with 47399 … 99214 average time = 25.

Health.mil – Business Support

… Control (DQMC) Program; HIPAA Transactions, Code Sets & Identifiers: …
Program Integrity · Rates and Reimbursement · Uniform Business Office (UBO) …

Medicaid Benefit Plan – Partners Behavioral Health Management

Dec 1, 2015 … Medicaid Basic Outpatient Services. Service Description. Benefit Limit. Level of
Care. Documentation Requirements. Assessment/Intake Codes:.

The Enlighten Newsletter – Advize Health

In 2013, the U.S. Department of Health and Human Services estimated that it
improperly spent about $65 billion in taxpayer funds …. Starting in 2016,
reimbursement will be decreased by 2 percent and will be based upon …. Let's
start with preventative medicine services (CPT codes 99381–99397). …. Example
: CPT 99214.

Derm Coding Consult – American Academy of Dermatology

cancer history. The Preventive Medicine services definition is similar to other ….
removed dermatology-specific CPT codes from their Modifier. -59 policy. ….. tions,
but not valid for use until October 1, 2013. … 1%. 2%. 1.5%. 4.5%. 2016. 2%. 2%.
2%. 6%. 2017 and beyond. 3%. 2%. 2%. 7% …. 99205, 99212, 99213, 99214, or.

icd-9 official coding guidelines for 2013

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By , August 14, 2015 7:24 pm

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icd-9 official coding guidelines for 2013

ICD-9-CM Diagnostic Coding Guidelines for Outpatient Services
Oct 19, 2006 … Ms. Von Kirchoff's ICD-9-CM knowledge base stems from a variety of …. CMS and
Outpatient Coding guidelines for Diagnostic Tests .

Guidelines Most Significantly Affected Under ICD-10-CM
May 29, 2013 … Analyze changes to ICD-10-CM Official Guidelines for Coding and … October 1,
2012 and 2013 -Limited updates to both ICD-9-CM and ICD-10 …

DRG 088 — Chronic Obstructive Pulmonary Disease ICD-9-CM …
Association, to be the official source for coding guidelines. Hospitals … guidelines
to assure accuracy in ICD-9-CM coding and DRG assignment. Definition of …

ICD-9-CM Coding – Cengage Learning
Nov 23, 2011 … Identify and properly use ICD-9-CM's coding conventions. 5. Accurately code …..
coding (CAC). © Cengage Learning 2013 … The ICD-9-CM Diagnostic Coding
and Reporting Guidelines for Outpatient Services: Hospital-.

Accidental Puncture or Laceration (PSI 15) – UHC
are inherent to the procedure and those that are an accidental complication.2
ICD-9-CM* Official Guidelines for Coding and Reporting states: Code assignment
 …
Chiropractic ICD9 Code List – ChiroCare
Use of valid ICD9 codes, billed with appropriate and corresponding CPT … In
addition, to remain consistent with the ICD9 CM Official Guidelines for Coding.
Preventive Services versus Diagnostic and/or … – Moda Health
Jan 14, 2015 … DRG guidelines, CMS' National Correct Coding Initiative …. List first the ICD-9-
CM code for the diagnosis, condition, problem, or other reason …
General Equivalence Mappings: ICD-9-CM to and from ICD-10-CM …
beyond October 1, 2013, which is the compliance date for … Translate ICD-9-CM
codes in the Official ICD-9-CM Coding Guidelines to aid in producing the …
Basic Introduction to ICD-10-CM/PCS – St. Mary's Health Care System
CPT coding for outpatient and office procedures is not affected by the. ICD-10
transition … ICD-9-CM.  ICD-10-CM Official Guidelines for Coding and.
Reporting accompany and complement ICD-10-CM conventions …. after October
1, 2013.
Coding for Anesthesia Services – The American Association of Oral …
… state board regulations. The codes utilized in this paper are from CPT 2013
and … to ICD-9-CM diagnostic coding and procedural coding guidelines utilizing
CPT, … and 2 of the ICD-9-CM cover diagnostic coding which is mandatory in
filing …
ICD-10 Quick Reference – UT Health Science Center at Houston
ICD-10-CM, including the ICD-10-CM Official Guidelines for Coding and
Reporting, … 9th Edition, Clinical Modification (ICD-9-CM) diagnosis code set in
all health care … dates of discharge for inpatients, that occur on or after October 1
, 2013.
Healthcare Coding, Billing & Reimbursement … – MinneAnalytics
Coding overview. ▫ ICD-9-CM and ICD-10-. CM codes. ▫ CPT and HCPCS
codes. ▫ Revenue …. Most health plans follow Medicare coding and billing
guidelines. □ Many ….. systems and conversion utilities after Oct. 1, 2013,
because not all.
Coding guide for routine HIV testing in health care settings
Background. In September of 2006, CDC issued recommendations for Human …
ICD-9-CM diagnosis codes1. 1. V70.0 routine … 1 ICD 9 codes are set to be
replaced with ICD 10 codes by Oct. 1, 2013 in the United States. Contact the US …
Federal Register/Vol. 79, No. 149/Monday, August 4, 2014/Rules …
Aug 4, 2014 … the Official ICD–10–CM Guidelines for. Coding and …. standard code set to
replace ICD–9–CM. … an October 1, 2013 compliance date for.
Coding Major Depressive Disorder – St. Vincent IPA!
Network, Feb. 2013. Web. 04 Dec. 2013. < http://www.cms.gov/Outreach-and-
Education/ … “ICD-9-CM Official Guidelines for Coding and Reporting.”
Department …
AHIMA Standards of Ethical Coding – RRHIMA
(updated April 2013). AHIMA Code of Ethics. ICD-9-CM Official Guidelines for
Coding and Reporting. AHIMA's position statement on Quality Health Data and …
Challenges and remediation for Patient Safety Indicators in the …
Dec 17, 2014 … Received 12 November 2013. Revised … ICD-9-CM codes are also utilized for
compulsory … reporting requirements to the federal government,.
V to Zee codes – DBR Visuals
ICD-9-CM. ICD-10-CM. Differences. Differences. *V Codes. *Z Codes. *
Supplemental Classification … ICD-10-CM OFFICIAL GUIDELINES FOR CODING
AND REPORTING. CHAPTER 21: FACTORS … A. October 1, 2013. B. October 1,
2014.
ICD-10-CM and ICD-10-PCS: Are YOU Getting … – Passport Health
Sep 3, 2010 … to the implementation of ICD-10-CM and ICD-10-PCS in 2013, do you … ICD-9-
CM diagnosis codes, they will be used in the same capacity as ICD- …
convention changes in the Official Guidelines for Coding and Reporting.
2013 CPT Coding Update – American Society for Gastrointestinal …
New CPT and HCPCS codes for reporting preparation of fecal microbiota. ….. The
2013 revisions to introductory guidelines throughout CPT continue the process …



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