Medically Directed / Supervised MODIFIER MODIFIER NARRATIVE PROVIDER TYPE ADDITIONAL MEDICARE INFORMATION AD Medical Supervision by a physician, more than four (4) concurrent anesthesia proceduresAnesthesiologistAllow three (3) base units, and one (1) additional base unit when it is demonstrated that the physician was present at the induction QKMedical direction of two, three, or four concurrent anesthesia…
The CLIA regulations require a facility to be appropriately certified for each test performed. To ensure that Medicare and Medicaid only pay for laboratory tests in a facility with a valid, current Clinical Laboratory Improvement Amendments (CLIA) certificate, laboratory claims are currently edited at the CLIA certificate level. The codes that are considered a laboratory…
View the Centers for Medicare & Medicaid Services (CMS) Announcement about Medicare Participation for Calendar Year 2015. Why participate?Medicare fee schedule amounts are 5% higher if you participate.Included in the Medicare Participating Directory (MEDPARD).Participants have “one stop” billing for beneficiaries who also have Medigap coverage and who assign their Medigap payments to the participant. When…
EMPIRE MEDICARE’S POLICY FOR ANESTHESIA AND GASTORINESTINAL ENDOSCOPY Patients undergoing gastrointestinal endoscopy receive medications for anxiety, discomfort and anesthesia, as well as monitoring during the procedure.CPT Codes00740 Anesthesia for upper gastrointestinal endoscopic procedures00810 Anesthesia for intestinal endoscopic proceduresHCFA’s National PolicyAnesthesia by the performing surgeon is not separately reimbursable to the surgeon.Indications…
Anesthesia Furnished in Conjunction with Colonoscopy Section 4104 of the Affordable Care Act defined the term “preventive services” to include “colorectal cancer screening tests” and as a result it waives any coinsurance that would otherwise apply under Section 1833(a)(1) of the Act for screening colonoscopies. In addition, the Affordable Care Act amended Section 1833(b)(1) of…
