Evaluation with a history of previous congenital anomaly.Follow-up evaluation of placental location for suspected placenta previa.Follow-up evaluation of a fetal anomaly.Evaluation for abnormal biochemical markers.Evaluation of prelabor rupture of membranes or premature labor.Evaluation of suspected placental abruption.Evaluation of suspected amniotic fluid abnormalities.Evaluation of suspected uterine abnormality.Evaluation of suspected ectopic pregnancy.Examination of suspected hydatidiform mole.Evaluation of discrepancy between uterine size and clinical dates.Adjunct to amniocentesis or other procedure.Evaluation of suspected multiple gestation.Evaluation of abdominal and pelvic pain.Tumor Antigen by Immunoassay CA 15-3/CA 27.
New York State Medicaid Expansion of Coverage of Group A Streptococcus Testing for Practitioners New Reporting Instructions for Colon Cancer Screening Anesthesia Services and New 2018 CPT Code Updates to the EmblemHealth Preventive Care/Screening Services Exempt from Cost-Share New ClaimsXten® Edits for Facility-Based Services New ClaimsXten Edits -Effective August 14, 2016 Modifiers for Services and Procedures During the Postoperative Period Modifier 25 with Evaluation and Management Services Reported with Procedures Modifier 24 with E/M Services During the Major and Minor Procedures Postoperative Period Maternity Claims: Multiple Birth Reimbursement Lung Cancer Screening with Low Dose Computed Tomography Frequency Important Coding Information with Regard to DME Modifiers HIPPS and Rate Codes for SNF and HHA Claims Required/ Keeping Accurate Documentation and Coding - Critical to Patient Care Global Surgery Reimbursement Policy Concerning an Unplanned Return to the Operating Room Modifier 78 will receive a 20% Fee Reduction* New and Revised Place of Service Codes (POS) for Outpatient HospitalĪnesthesia for Pain Management Injections –Commercial (Updated)īilling Instructions for Long Acting Injectable Antipsychotics, Vivitrol and Injectable NaloxoneĬanalith Repositioning Therapy – CPT 95992Ĭardiovascular Evaluation with Tilt Table Testing –CPT code 93660Ĭhange in CPT Codes for Qualitative Drug Screen TestingĬlinical Laboratory Improvement Amendment Waived TestsĬMS Requires HIPPS and Rate Codes for SNF and HHA ClaimsĬoding Antepartum Care by Different Provider GroupsĬomplete and Accurate Medical Record Documentation and Coding Critical to Patient CareĬorrect Bundling of Urinalysis CPT Codes 8103 With Evaluation and Management CPT CodesĬorrect Laterality ICD-10-CM Diagnosis Coding PolicyĬorrect Usage of Modifier 50 and Modifiers LT and RT for Bilateral ProceduresĬPT Code 31634 Considered Unproven Technologyĭiscontinue Use of CPT Codes Retired January 1, 2012ĭuplicate Claims from a Non-Physician PractitionerĮffective Coding of Evaluation and Management ServicesĮvaluation and Management Codes Not Payable to Audiology and Speech Language Pathology SpecialtiesĮxpanded Coverage for Fragile X Syndrome - Prenatal Carrier TestingĮxpanded Coverage for Spinal Muscular Atrophy - Prenatal Carrier TestingĮxtracorporeal Photopheresis (CPT code 36522) National Drug Code (NDC) Requirements for Drug Claimsĭenial of CPT Codes Billed With Bariatric SurgeryĮmblemHealth 5010 HIPAA Transaction Standard Companion GuidesĮmergency Ground Ambulance Destination Modifier EmblemHealth Preventive Care/Screening Services Coverage (Revised)ĮmblemHealth Guide for NPIs and Taxonomy CodesĪdditions to the Self-Referral Payment Policy List
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