CPT Modifier 78 & Modifier 79 | Usage Guidelines

CPT Modifier 78 & Modifier 79 | Usage Guidelines

Modifier 79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Modifier 78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period Anesthesia, CCI Editing, Global Days, Multiple Procedure Reduction, Rebundling The physician may…

Pre & Post Anesthetic Services And Eligible Providers

Pre-anesthetic Evaluations and Post-operative Visits MHCP uses the CMS list of base values, which were adopted from the relative base values established by the ASA. The base value for anesthesia services includes usual pre-operative and post-operative visits. No separate payment is allowed for the pre-anesthetic evaluation regardless of when it occurs unless the recipient is…

What Is Conscious Sedation & Deep Sedation?

Conscious SedationThe intent of conscious sedation is for the patient to remain conscious and able to communicate during the entire procedure. The patient retains the ability to independently and continuously maintain a patent airway and respond appropriately to physical stimulation and/or verbal command. Conscious sedation includes performance and documentation of pre- and postsedation evaluations of…

Anesthesia Direction Guidelines For Medical Coding

Anesthesia Direction Guidelines For Medical Coding

Anesthesiologists can be reimbursed for the personal medical direction (as distinguished from supervision) that they furnish to CRNAs. Criteria For Medical Direction Medical direction services personally performed by an anesthesiologist will be reimbursed only if the anesthesiologist: Performs a pre-anesthetic examination and evaluation; Prescribes the anesthesia plan; Personally participates in the most demanding procedures in…

What is Qualifying Circumstances?

Qualifying circumstances are those factors such as extreme age, extraordinary condition of the patient, and unusual risk factors which may affect the anesthesia services. These procedures are considered add-on codes and would not be reported alone, but as additional procedures qualifying an anesthesia procedure or service. These procedures must be filed with the appropriate modifier….

Guidelines For CPT 0017u, CPT 0037u, CPT 81445, CPT 81450 & CPT 81455

Guidelines For CPT 0017u, CPT 0037u, CPT 81445, CPT 81450 & CPT 81455

Coding Code Description CPT 0017U Oncology (hematolymphoid neoplasia), JAK2 mutation, DNA, PCR amplification of  exons 12 – 14 and sequence analysis, blood or bone marrow, report of  JAK2 mutation not detected or detected 0037U Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324  genes, interrogation for sequence variants, gene copy number  amplifications, gene …