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Posting Date: 10/02/2024
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin L39513 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39513&ver=3&contractorName=1[...]
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Posting Date: 10/02/2024
Pain Management
Pain Management spine, spinal, trigger, injection, ganglion L33622 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33622 A52863 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52863 A59302 [...]
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Posting Date: 10/02/2024
Vitamin D Assay Testing
Vitamin D Assay Testing Bone Density, Osteopenia L37535 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37535 A57736 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57736 A55852 [...]
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Posting Date: 04/02/2024
Medicare Preventive Services Resource Guide
Medicare Preventive Services Resource Guide Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep Medicare beneficiaries [...]
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Posting Date: 08/05/2022
Anesthesia Modifiers
Anesthesia Modifiers Use Anesthesia Modifiers Appropriately National Government Services requires placement of pricing modifiers in the first modifier position to process your anesthesia claims correctly. Claims submitted incorrectly will [...]
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Posting Date: 08/04/2022
Appropriate Usage of Modifier 99
Appropriate Usage of Modifier 99 Table of Contents Appropriate Usage of Modifier 99 Appropriate Usage Inappropriate Usage Related Content [Return to Top] Appropriate Usage of Modifier 99 Modifier 99 indicates multiple modifiers; [...]
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Posting Date: 08/04/2022
Correct Usage of Modifier 79 for Multiple Procedures
Correct Usage of Modifier 79 for Multiple Procedures National Government Services Medical Review department has identified widespread problems with the use of modifier 79 for multiple procedures. The global surgical package was established by [...]
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Posting Date: 08/04/2022
Co-Surgery/Team Surgery/Assistant Surgery Modifiers
Co-Surgery/Team Surgery/Assistant Surgery Modifiers Table of Contents Co-Surgery/Team Surgery/Assistant Surgery Modifiers Co-Surgery (Modifier 62) Team Surgery (Modifier 66) Assistant-at-Surgery Services Assistant Surgery Modifiers [...]
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Posting Date: 08/04/2022
Modifier 51
Modifier 51 Table of Contents Modifier 51 Definitions Appropriate System Usage Inappropriate System Usage Additional Information Related Content [Return to Top] Modifier 51 Modifier 51 denotes more than one medical/surgical [...]
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Posting Date: 08/05/2022
Modifier 59 and the Subset Modifiers XE, XP, XS, XU - Specific Modifiers for Distinct Procedural Services
Modifier 59 and the Subset Modifiers XE, XP, XS, XU – Specific Modifiers for Distinct Procedural Services Table of Contents Continued Use of Modifier 59 after 1/1/2015 Modifier 59 Appropriate Usage Modifier XE Modifier XP [...]
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Posting Date: 08/30/2022
Proper Billing of Surgical Comanagement (Modifiers 54 and 55)
Proper Billing of Surgical Comanagement (Modifiers 54 and 55) Table of Contents Proper Billing of Surgical Comanagement (Modifiers 54 and 55) Exceptions Date(s) of Service Care Provided in Different Payment Localities 55 Modifier [...]
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Posting Date: 03/29/2022
Critical Care Policy Clarification
Critical Care Policy Clarification The CMS implemented the new policy for critical care services as published in the Centers for Medicare & Medicaid Services Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, [...]
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Posting Date: 02/01/2022
Critical Care Tip Sheet
Critical Care Tip Sheet Table of Contents Service and Medical Necessity The Following CMS Billing Consideration Guidelines Apply Provider Time Assessment and Documentation The Following CMS Billing Consideration Guidelines [...]
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Posting Date: 04/26/2022
Critical Care Services: CPT Codes 99291-99292
Critical Care Services: CPT Codes 99291-99292 Table of Contents Definition Context Providers Who May Perform Critical Care Services and Medical Necessity Palliative and Hospice Patients Full Attention of the Provider and Provider [...]
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Posting Date: 10/20/2017
Certification or Recertification of Medicare Covered Home Health Services
Certification or Recertification of Medicare Covered Home Health Services Billing HCPCS Codes G0180 and G0179 of Patient Eligibility for Medicare-covered Home Health Services under a Home Health Plan of Care Physician [...]
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Posting Date: 11/13/2020
Initial Episode Clarified for Home Health Face-to-Face Encounter
Initial Episode Clarified for Home Health Face-to-Face Encounter CMS requires a patient receiving HH services under the Medicare HH benefit have a FTF encounter with the certifying physician for the initial episode. CMS has clarified that this [...]
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Posting Date: 03/13/2023
Sacroiliac Joint Injections and Procedures
Sacroiliac Joint Injections and Procedures Table of Contents Sacroiliac Joint Injections and Procedures Diagnostic SIJI Diagnostic SIJI Limitations Therapeutic SIJI Therapeutic SIJI Limitations SIJ Denervation [...]
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Posting Date: 02/14/2024
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only Physician and nonphysician practitioners who can enroll in Medicare solely to order or refer: Doctors of medicine or osteopathy Doctors of dental surgery [...]
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Posting Date: 02/02/2021
Approval or Denial
Approval or Denial Approval Once your application is approved, you will receive an emailed, faxed or mailed Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]
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