Anesthesia|Pain Management Articles and Resources
News and Important InformationI. Code SetsAnesthesia CPT CodesCPT codes for Anesthesia II. Find-A-Code's Tools & ResourcesASA CrosswalksCrosswalk from CPT Anesthesia Codes to Surgery and Procedure Codes. ASA Crosswalks TutorialTutorial Video for ASA Crosswalk Add-on Anesthesia Fee CalculationFees for anesthesia services are not calculated the same as for other types of procedures... NCCI Edits ValidatorValidate using NCCI edits for errors in code selection. WK Drug DatabaseSearch by keywords or codes, click on an index letter to see drugs by name, or drill down through the GPI hierarchy. Click-A-DexFor quick drill-down and easy code selection. Build-A-CodeStep-by-step coding from all major code sets. Pro Fee CalculatorVerify Medicare Reimbursement and UCR Fees for Professional Services Physical Status ModifiersUsing Physical Status Modifiers with Anesthesia Codes III. Additional Links and ResourcesAnesthesia CPT GuidelinesOfficial CPT Section Guidelines ASA Standards and GuidelinesAmerican Society of Anesthesiologists Standards and Guidelines Chronic Pain AssignmentPain Management Programs Injection TherapiesPain Management Injection Therapies for Low Back Pain Pain Management Critical ElementsStage 2 Critical Elements for Pain Recognition and Management Pain Management OptionsHHS.Gov: Pain Management Options Anesthesiologists CenterCMS Anesthesiologists Center Noridian: Anesthesia ResourcesNoridian JE Part B Anesthesia and Pain Management Resources Medicare Provider WebsiteFind the latest Medicare news. Drugs and Biologicals Pub-100 Ch 17Drugs and Biologicals Pub-100 Ch 17 Billing Requirements for OPPSBilling Requirements for OPPS Providers with Multiple Service Locations Reimbursement PolicyOxford's reimbursement policy for anesthesia services Select the title to see a summary and a link to the full article. August 16th, 2019 Medical ID Theft| Published August 16th, 2019 - Last Review/Update August 20th, 2019 Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ... August 9th, 2019 The OIG Work Plan: What Is It and Why Should I Care?| Published August 9th, 2019 - Last Review/Update August 14th, 2019 The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ... July 12th, 2019 5 Ways to Minimize HIPAA Liabilities| Published July 12th, 2019 - Last Review/Update July 30th, 2019 Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability.
Take ... May 13th, 2019 Electrical Stimulation and Electromagnetic Therapy Devices| Published May 13th, 2019 - Last Review/Update May 20th, 2019 Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint. April 1st, 2019 Spinal Cord Stimulator Used for Chronic Pain| Published April 1st, 2019 Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes.
ICD-10-CM Diagnosis Codes ... October 17th, 2018 Wolters Kluwer Drug Pricing| Published October 17th, 2018 Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average... January 29th, 2018 Anesthesia Documentation Modifiers - Jurisdictions: J8A, J5A, J8B, J5B| Published January 29th, 2018 Documentation Modifiers direct prompt and correct payment of the anesthesia claims submitted. Documentation modifiers (AA, QK, AD, QY, QX and QZ) must be billed in the first modifier field.
If a QS modifier applies, it must be in the second modifier field. Processing delays and denials may occur for claims submitted ... January 29th, 2018 Anesthesia and Fee Calculation| Published January 29th, 2018 - Last Review/Update April 16th, 2020 Fees for anesthesia services are not calculated the same as for other types of procedures. There are four elements to consider when calculating anesthesia fees. Medicare accepts base units and time units; however, depending on the third party payer, they may or may not accept physical status units and/or qualifying circumstances units.
Base Unit (of the CPT code)
Time (in ... January 9th, 2018 Coverage and/or Medical Necessity for the Use of Hyaluronan or Derivitive| Published January 9th, 2018
According to Palmetto GBA, Medicare will cover the cost of the injection and the injected hyaluronate polymer for patients who meet the following clinical criteria:
Knee pain associated with radiographic evidence of osteophytes in the knee joint, sclerosis in bone adjacent to the knee, or joint space narrowing.
Morning stiffness of less than 30 minutes in duration or crepitus on motion of the ... Select the webinar title to view a summary and link to the webinar video. January 4th, 2018 Proper Coding and Billing for Drugs, Biologicals and InjectionsProper Coding and Billing for Drugs, Biologicals and Injections February 2nd, 2017 How to Check NCCI Edits Using FindACodeHow to Check NCCI Edits Using FindACode 2020 Pain Management ICD-10-CM Coding Book2020 Pain Management Reimbursement GuideAdvanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolBilateral Surgeries: Claim SubmissionCommonly Used Medicare Modifiers - GA, GX, GY, GZFederal Opioid Treatment StandardsMedicare Part B Clinical Laboratory Fee ScheduleNoridian: Allowed Amount ReductionsPhysician Assistant (PA) Resources NoridianSummary of the HIPAA Privacy Rule by HHS
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