-
Posting Date: 06/09/2017
Smoking Cessation
Smoking Cessation Please clarify appropriate codes for smoking cessation services. Answer: CPT codes 99406 and 99407 may be used for smoking and tobacco-use cessation counseling visits. Please clarify what constitutes a session which [...]
Read More -
Posting Date: 01/04/2023
Skilled Nursing Facility Services
Skilled Nursing Facility Services Please define rules for initial and subsequent SNF services, when the same provider has treated the patient at another site on the same date of service. Answer: This depends on the site of the prior [...]
Read More -
Posting Date: 08/29/2017
Separately Identifiable Service
Separately Identifiable Service Please define the appropriate use of modifier 57 to identify a separately payable E/M with an initial decision for surgery. Answer: Modifier 57 is added to an E/M service that resulted in an initial [...]
Read More -
Posting Date: 01/28/2022
Provider Specialty
Provider Specialty Should each MD in the same practice bill with two different taxonomy codes based on whether functioning as a cardiologist or electrophysiologist? Answer: Yes, providers should be billing with their taxonomy codes. The [...]
Read More -
Posting Date: 04/01/2022
Prolonged Services
Prolonged Services Note: View the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.15.2 and Section 30.6.15.3 for CPT codes [...]
Read More -
Posting Date: 01/28/2022
Preoperative Clearance
Preoperative Clearance What requirements must be met for a preoperative clearance visit to be considered medically necessary and billable? Answer: CMS does not set requirements for medical clearance; these are established by individual [...]
Read More -
Posting Date: 10/26/2022
Nonphysician Practitioner Services
Nonphysician Practitioner Services In addition to the frequently asked questions below, please view NGS’ Nonphysician Practitioners-Reducing Costly Appeals; Increase Provider Revenue article for related information. Is it permissible for [...]
Read More