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Scenario One: Billing for locum tenens coverage for an absent physician If a physician is absent for a limited period of time for vacation, disability, continuing education, etc, you may bill Medicare for services performed by a locum tenens physician under the regular physician’s NPI as... Continue Reading
The nuchal translucency ultrasound scan and blood tests are often done together in what is called the combined first-trimester genetic screen. Part of the first trimester genetic screen uses ultrasound to measure the thickness of the area at the back of the baby's neck. Obtaining the biochemical... Continue Reading
Effective Jan. 1, 2015, the Centers for Medicare & Medicaid Services (CMS) implemented four new modifiers to define specific subsets of the 59 modifier. These new modifiers are referred to as X{EPSU} modifiers, and are more selective versions of modifier 59. Current procedural terminology... Continue Reading
When ICD-10 is implemented in October, 2015, a significant change for MFM will be the ability to assign a condition to a specific fetus in multiple gestation pregnancies. This is done using a 7th character on the ICD-10 code for certain categories. The designations are: 0 = not applicable or... Continue Reading
When performing diagnostic amniocentesis on a twin gestation with two amniotic sacs (two separate taps), you would report the procedures as follows: · 59000 Amniocentesis, Twin A · 76946 (or 76946-26) Amnio Guidance, Twin A · ... Continue Reading
How is continuous NST monitoring billed when a patient is admitted to the hospital? Inpatient continuous fetal heart rate and/or uterine contraction monitoring is not billed as non-stress test (59025) or contraction stress test (59020). Instead, continuous monitoring is included in the... Continue Reading
CPT code 93975 describes duplex scan of arterial inflow and venous outflow of abdomen, retroperitoneum, scrotal contents and/or pelvic organs. This code applies to a complete evaluation, and may be used whether single or multiple organs are studied. It is a "complete" study, in that all major... Continue Reading
When an invasive antenatal procedure is performed, confirmation of the fetal heart beat or a systole post procedure is in included in the work of the procedure and should not be billed separately. Invasive Antenatal Procedures: 1. 59000 Amniocentesis; diagnostic and 76946 Ultrasonic... Continue Reading
A recent question was asked on the correct way to report an Umbilical Cord Occlusion via the Radio Frequency Ablation approach”. Below you will find two examples of multi-fetal reductions, their approach and correct coding guidance for billing purposes. Types of Fetal Reductions and... Continue Reading
Some payers have frequency guidelines related to Obstetrical ultrasound services, and will only pay for a certain number of scans per pregnancy, regardless of diagnosis and complications, provider specialty or practice tax ID. It is important to be aware of these contractual restrictions, and... Continue Reading
99446 Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and... Continue Reading
The National Uniform Claim Committee (NUCC) has approved a transition timeline for the version 02/12 1500 Health Insurance Claim Form (also known as CMS-1500).In June, the NUCC announced the approval of the updated paper 1500 ClaimForm that accommodates reporting needs for ICD-10. The new 1500... Continue Reading
