For the Week of November 23, 2015
How are HCV adult screening tests performed in the hospital outpatient department paid under Medicare?
In a transmittal issued on November 5, 2015, the Centers for Medicare & Medicaid Services (CMS) added type of bill (TOB) 014x (hospital other Part B) as an applicable TOB for the screening of HCV when submitted for a non-patient laboratory specimen (HCPCS Code G0472). CMS will implement this change on April 4, 2016 but it will be effective for dates of service on or after June 2, 2014. Payment for these services will be based on the laboratory fee schedule. For this transmittal, go to https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3393CP.pdf.
If a cardiologist documents acute myocardial infarction (AMI) in the history, and a stent was placed into the left main artery, can we report the code below?
92941 Percutaneous transluminal revascularization of acute total/subtotal occlusion during AMI, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
How do we determine the units of a drug administration to report on a claim?
Would it be a contrast-only MRI/MRA scan if localizer scans only are done pre-contrast and most of the diagnostic imaging is done only after contrast administration? In other words, would a non-contrast followed by contrast scan code only apply if additional imaging beyond localizers was done after contrast?
What is included in code 94002 for ventilation management?
According to a new entry in the National Correct Coding Initiative Manual that takes effect on January 1, 2016, practitioner ventilation management (e.g., CPT codes 94002–94005, 94660, 94662) and critical care (e.g., CPT codes 99291, 99292, 99466–99486) include respiratory flow volume loop (CPT code 94375), breathing response to carbon dioxide (CPT code 94400), and breathing response to hypoxia (CPT code 94450) testing if performed.
Are full signatures required on changes to medical record documentation or are initials allowed?