MEDICAL BILLING AND CODING

Sunday, September 29, 2013

G0108 and G0109

Medicare provides advantage of diabetes self-management training (DSMT) casework for beneficiaries who accept been afresh diagnosed with diabetes, bent to be at accident for complications from diabetes, or were ahead diagnosed with diabetes afore affair Medicare accommodation requirements and accept back become acceptable for advantage beneath the Medicare Program
A able DSMT affairs includes the afterward services:
 Instructions in self-monitoring of blood glucose,
 Education about diet and exercise,
 An insulin analysis plan developed accurately for insulin abased patients, and
 Motivation for patients to use the abilities for self-management.
DSMT casework are aimed against individuals with Medicare who accept afresh been impacted in any of the afterward situations by diabetes:
Problems authoritative claret sugar,
Beginning diabetes medication, or switching from articulate diabetes medication to insulin,
Diagnosed with eye ache accompanying to diabetes,
Lack of activity in anxiety or added bottom problems such as ulcers or deformities, or an amputation hasbeen performed,
Treated in an emergency allowance or accept backward brief in a hospital because of diabetes, or
Diagnosed with branch ache accompanying to diabetes.``
Coverage Information
Medicare provides advantage of DSMT casework alone if the alleviative physician or alleviative qualifiednon-physician practitioner managing the beneficiary’s diabetic action certifies that DSMT casework are needed. The apropos physician or able non-physician practitioner charge advance a plan of affliction in the beneficiary’s medical almanac and affidavit substantiating the charge for training on an alone base back accumulation training is about covered, if ordered. The adjustment charge additionally accommodate a account active by the physician or able non-physician practitioner that the account is bare as able-bodied as thefollowing information:
The cardinal of antecedent or after effect hours ordered
The capacity to be covered in training , and
A assurance if the almsman should accept alone or accumulation training.
Procedure Codes and Descriptors
The afterward Healthcare Common Procedure Coding System  codes listed are acclimated to address DSMT services
G0108 - Diabetes outpatient self-management training services, individual, per 30 minutes
G0109 - Diabetes outpatient self-management training services, accumulation affair , per 30 minutes

Tuesday, September 24, 2013

H - Modifier



H9 COURT ORDERED
HA CHILD/ADOLESCENT PROGRAM
HB ADULT PROGRAM, NON GERIATRIC
HC ADULT PROGRAM, GERIATRIC
HD PREGNANT/PARENTING WOMEN'S PROGRAM
HE MENTAL HEALTH PROGRAM
HF SUBSTANCE ABUSE PROGRAM
HG OPIOID ADDICTION TREATMENT PROGRAM
HH INTEGRATED MENTAL HEALTH/SUBSTANCE ABUSE PROGRAM
HI INTEGRATED MENTAL HEALTH AND MENTAL RETARDATION/DEVELOPMENTAL DISABILITIES
HJ EMPLOYEE ASSISTANCE PROGRAM
HK SPECIALIZED MENTAL HEALTH PROGRAMS FOR HIGH-RISK POPULATIONS
HL INTERN
HM LESS THAN BACHELOR DEGREE LEVEL
HN BACHELORS DEGREE LEVEL
HO MASTERS DEGREE LEVEL
HP DOCTORAL LEVEL
HQ GROUP SETTING
HR FAMILY/COUPLE WITH CLIENT PRESENT
HS FAMILY/COUPLE WITHOUT CLIENT PRESENT
HT MULTI DISCIPLINARY TEAM
HU FUNDED BY CHILD WELFARE AGENCY
HV FUNDED STATE ADDICTIONS AGENCY
HW FUNDED BY STATE MENTAL HEALTH AGENCY
HX FUNDED BY COUNTY/LOCAL AGENCY
HY FUNDED BY JUVENILE JUSTICE AGENCY
HZ FUNDED BY CRIMINAL JUSTICE AGENCY

Wednesday, September 18, 2013

Spirometry Reimbursement Guidelines

94010 - Spirometry  including calculation of the FVC, FEVI, and
optionally ow rate measurements. A graphic record as well as an interpretation must be included


94060 Bronchospasm Evaluation - Spirometry as in 94010 above before and after administration of a bronchodilator 


95070 Inhalation Challenge Testing with histamine, methacholine or similar bronchoprovocation agent

94070 Functional Residual Capacity Multiple spirometric determinations after bronchodilator with spirometry as in 94010


94150 Vital Capacity - Spirometry, Slow Vital Capacity


94200 Maximum Voluntary Ventilation - Maximum breathing capacity, maximum volume ventilation


94375 Flow Volume Loop - Respiratory ow volume loop


94664 Bronchodilator Administration - Aerosol or vapor inhalation.



ICD-9 Codes for Spirometry

466 - 466.19     Acute bronchitis and bronchiolitis
490                 Bronchitis, not specified

491 – 491.9      Bronchitis Chronic

492 – 492.8      Emphysema

493 – 493.91    Asthma 
494                 Bronchitis


496                  Chronic airway obstruction, not elsewhere classified

508 – 508.9      Respiratory condition due to other and unspecified external agents
518.9               Other diseases of respiratory system
519.1               Bronchospasm
780.51             Insomnia with sleep apnea 
786.2               Cough
780.53              Hyperinsomnia with sleep apnea
793.1              Abnormal chest x-ray
786                 Abnormal chest sounds
277                 Cystic Fibrosis 
790.7              Chronic fatigue  
787                Heartburn 

E942.9           Other unspecified agents primarily affecting the cardiovascular system
305.1             History of tobacco abuse

V13.8             History of thyroid disorder