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Posts tagged: 45378

procedure code 45378

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By , June 12, 2016 2:05 pm

procedure code 45378

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Key to MPFSDB Indicators for 2016 – WPS

Dec 29, 2015 … The formula for 2016 physician fee schedule payment amount is as follows: ….
colonoscopy CPT code 45378, or with G0105 and G0121.

HEDIS Measures 2016

Nov 5, 2015 … 2016 HEDIS® & Quality Assurance Reporting Requirements Measures. Provider
… Substance Use CPT II: 3016F, 4290F, 4306F, 4320F … 44397, 45355, 45378,
45379, 45380, 45381, 45382, 45383, 45384,. 45385, 45386 …

Section 11: Billing Requirements – PacificSource

Revised January 1, 2016. … follows the HCPCS guideline: If a valid CPT code is
available, … a CPT code-identified procedure, the patient's condition ……
Example 1: The procedures performed are 45378 (B), 45385, and 45380 and are
based …

Preventive Services versus Diagnostic and/or … – Moda Health

Dec 16, 2015 … depending upon the primary diagnosis code with which it is billed. …. The
remainder of lab procedure codes and diagnostic services are covered …. 45378.
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with …. Official ICD-
10-CM Guidelines for Coding and Reporting, §IV, G. ICD-9-CM 2016.

Section 2: Mastering Billing with Modifiers

CPT is a registered trademark of the American Medical Association. 2016
Physician Practice Billing Answers … surgery rules do not apply to that procedure
. … In the course of performing a fiber optic colonoscopy (CPT code 45378), a.

American College of Gastroenterology – Policy and Medicine

Sep 2, 2014 … 2016. As our societies have stated in previous comment letters, … Appendix G of
the CPT® book to ensure that moderate sedation is typical for the procedures ….
time from the previous review of colonoscopy base code 45378 …

here – McKesson

Aug 18, 2015 … Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2016. This year …..
table in Federal Registry for CPT code description). TABLE 46: ….. 45378. 45379.
45380. 45381. 45382. 45384. 45385. 45386. 45388. 45389.

Download the PDF – DHPA

Sep 8, 2015 … to Part B for Calendar Year 2016 (CY 2016) Proposed Rule (CMS-1631-. P),
published in … and treat colorectal cancer in a single procedure.

Blue Cross Medicare Advantage Section Of The Blues Provider

January 2016. Page S1. Table of ….. ICD-9 diagnosis codes (or ICD-10 codes
when mandated). •. CPT. ® …… GI Endoscopy – 45378 effective February 1, 2016
.

ASC – American Society of Cataract and Refractive Surgery

Apr 1, 2014 … assigned by the AMA, are not part of CPT, and the AMA is not … CY 2016. ASC-6:
Safe Surgery Checklist Use. January 1, 2014 thru …… CPT or HCPCS: 44388,
44389, 44392, 44393, 44394, 45355, 45378, 45380, 45381,.

Third Party Payer Q and A – wmgma

there is an E/M code for online visits, there is not a CPT code that defines an E/M
service being … 2016 and we will send out update when decision has been
made. ….. modifier 52 or would it be appropriate to report CPT 45378 –
Colonoscopy, …

UCare Products for 2016 Click Here UCare's 2016 Service Area by …

Nov 2, 2015 … Care Plan Benefit Changes for. 2016. All UCare providers: Provider …..
Additional diagnosis codes may be reported as secondary or subsequent codes
…. For procedures codes 45378, G0105, and G0121 submitted with a -53.

FY 2016 MCRCEDP Unit Cost Reimbursement Rate Schedule

Jul 17, 2015 … FY 2016. MCRCEDP. Unit Cost Reimbursement Rate Schedule. FY16. 1 …
45378. $389.74. $222.27. $222.27. 2. Discontinued Procedure- Colonoscopy,
flexible, proximal to splenic flexure …. code for primary procedure) a.

2016 HEDIS®/QRS/QARR/EES Physician Documentation …

2016 HEDIS®/QRS/QARR/EES Physician Documentation Guidelines and
Administrative … CPT: 44388-44394, 44397, 45355, 45378-45387, 45391, 45392
.

General Coverage – First Coast Service Options, Inc.

Nov 2, 2015 … ICD-10 diagnosis codes were posted to the Medicare coverage database (MCD)
….. adjust affected claims on or before January 19, 2016. Status/date ….. report an
incomplete colonoscopy with 45378 and append modifier 53 …

HEDIS measure: Colorectal Cancer Screening – Blue Cross and …

45355, 45378-45387,. 45391, 45392. G0105, G0121. Codes to identify
Colorectal Cancer Screening … Submit a claim for FOBT (CPT 82270 or 82274)
when the.

2016 HEDIS®1 Measures – Healthcare … – Optima Health

Codes to identify PSA-based Screening. CPT: 84152-84154 …. 45378-45387;
45391; 45392 … Exclusion: Diagnosis of colorectal cancer or total colectomy.

2016 HCPCS Level II Expert – OptumCoding

in this book is a reproduction of the 2016 HCPCS; additional information on
coverage issues … Codes in the Optum HCPCS Level II follow the AMA CPT
book.

Medicare Bulletin – May 2015 – CGS

May 5, 2015 … Ohio example: CPT code 45378 (no modifiers), facility setting …. and finalized in
the CY 2016 Medicare Physician Fee Schedule proposed and …

Section 12, Part 2 – Fidelis Care

V16.0 – 1/4/2016. 12.2.1 … Common Procedure Coding System (HCPCS) and
International … ICD- Diagnosis Code(s), valid and coded to the appropriate digit.
X ….. 45378. Diagnostic colonoscopy. 45385. Lesion removal colonoscopy.
45384.

procedure 45378

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By , May 20, 2016 5:23 am

procedure 45378

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CMS 2015 G-Codes for Lower GI Endoscopy Procedures Frequently …

Dec 17, 2014 … of the code descriptor. For those existing procedures with new CPT codes, CMS
created G-codes … values for all lower GI endoscopy procedures, including
colonoscopy, in the 2016 Medicare. Physician Fee … 45378, G6021.

Key to MPFSDB Indicators for 2016 – WPS

Dec 29, 2015 … procedure's relative value unit (i.e., the RVUs for work, practice expense, and …
The formula for 2016 physician fee schedule payment amount is as follows: ….
colonoscopy CPT code 45378, or with G0105 and G0121.

Section 11: Billing Requirements – PacificSource

Revised January 1, 2016. Replaces all … a CPT code-identified procedure, the
patient's condition …… Example 1: The procedures performed are 45378 (B),
45385, and 45380 and are based on 2009 Fully Implemented Facility RVUs. CPT
.

Coding Summary for Providers – UnitedHealthcareOnline.com

Effective January 1, 2016 p. 1 of 19. Coding … Procedure Code(s): 97802 –
97804, 99401 – 99404, G0270, G0271, G0446, G0447,. G0473, S9470, 0403T
….. 45346, 45378, 45380, 45381, 45384, 45385, 45388 82270, 82274. Code
Group 3 …

UCare Products for 2016 Click Here UCare's 2016 Service Area by …

Nov 2, 2015 … Care Plan Benefit Changes for. 2016. All UCare providers: Provider ….. For
procedures codes 45378, G0105, and G0121 submitted with a -53.

Summary of the 2016 MPFS Proposed Rule

Sep 8, 2015 … For CY 2016, CMS has incorporated the available utilization data …. due to
changes in technology and technique, several codes that describe …… CPT code
45378 reported with the -53 modifier will now describe a more …

HEDIS Measures 2016

Nov 5, 2015 … 2016 HEDIS® & Quality Assurance Reporting Requirements Measures … 44397,
45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, …. HCPCS:
Healthcare Common Coding Procedure Coding System Level II.

FY 2016 MCRCEDP Unit Cost Reimbursement Rate Schedule

Jul 17, 2015 … ASC 45378-SG. Hospital/Facility. **. 45378. $389.74. $222.27. $222.27. 2.
Discontinued Procedure- Colonoscopy, flexible, proximal to splenic.

Section 2: Mastering Billing with Modifiers

2016 Physician Practice Billing Answers. Section 2: … “If Field 21 for any of the
multiple procedures contains an indicator of '0,' the multiple … 45378 – $255.40.

use Modifier 51 to i

Modifier 51 Multiple Procedures: use Modifier 51 to indicate that multiple …
Colonoscopy (45378) performed at the same session as upper endoscopy (
43200).

Medicare Reimbursement – Back to the Basics – MedAssets

provide an outpatient procedure or service. Facility …. rate for an APC, use the
following steps to calculate your wage adjusted payment … for CPT 45378,
calculate the payment for this ….. Services (HHS) presented its budget for 2016
during a.

August 19, 2014 Marilyn Tavenner, MHA, BSN, RN Administrator …

Aug 19, 2014 … We believe the first step in this process to accurately review upcoming changes
in … include scheduled reimbursement changes to be in the annual proposed
rules beginning in CY 2016. … colonoscopy base code 45378.

New Affordable Care Act (ACA) Medical … – Premera Blue Cross

Columbia Medical Associates created an efficient process and seamlessly
implemented it into their daily … 1, 2016, Premera will launch a new
PersonalCare Partner Systems network that will support …… Procedure code
45378 or G0121.

CY 2016 Medicare Physician Fee Schedule Final Rule – AAMC

Dec 3, 2015 … Payment update for 2016 (Conversion factor) … 99498 should be listed
separately from primary procedure ….. 45378 Diagnostic colonoscopy.

Physicians Provider – South Carolina Department of Health and …

Jul 8, 2011 … Updated January 1, 2016 …. PROCEDURE CODES FOR CHECKUP AND
FAMILY PLANNING . ….. Added procedure code 45378. • Updated …

2015-2016 Maximum Reimbursement Rates

Apr 1, 2015 … 4/1/2015 – 3/31/2016 … 477.64. Stereotactic biopsy procedure- breast-all
inclusive of placement of breast … 45378 or G0121 or G0105.

2016_PQRS_Measure_439_11_17_2015.pdf – MDinteractive

Nov 17, 2015 … Patients who have a coded colonoscopy procedure that has a … the reporting
period (CPT or HCPCS): 45378, 45380, 45381, 45384, 45385,.

2016 HCPCS Level II Expert – OptumCoding

Procedures/Professional Services (Temporary)………………. 39 …. in this book is a
reproduction of the 2016 HCPCS; additional information on coverage issues …

(ASC) Prospective Payment System: 2012 Final Rule

Nov 1, 2011 … beginning in CY 2013 for the CY 2015 and CY 2016 payment determinations —
one for safe surgery checklist use … CMS continues to exclude from ASC
payments some procedures that are …. 45378 Diagnostic colonoscopy.

2016 Benefits Guide (PDF) – Schurz Communications Inc.

SCHURZ CHOICE 2016 BENEFIT & WELLNESS GUIDE ….. and you do not
actively participate in the open enrollment process and certify ….. 45378-45385.

cpy 45378 covered for medicare

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By , April 17, 2016 6:30 am

cpy 45378 covered for medicare

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Key to MPFSDB Indicators for 2016 – WPS

Dec 29, 2015 … This file contains information on services covered by the Medicare. Physician Fee
…. colonoscopy CPT code 45378, or with G0105 and G0121.

Summary of the 2016 MPFS Proposed Rule

Sep 8, 2015 … CY 2016 Medicare Physician Fee Schedule …… RUC recommendations included
CPT tracking codes instead of the … CPT code 45378 reported with the -53
modifier will now describe a more resource-intensive group of.

Centers for Medicare & Medicaid Services (CMS) – McKesson

Aug 18, 2015 … Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2016. This year ….
certain other suppliers under the PFS which pays for covered physicians'
services furnished to a ….. 17 The CPT codes identified are 31254, 31255, 31256
, ….. 45378. 45379. 45380. 45381. 45382. 45384. 45385. 45386. 45388.

Medicare Reimbursement – Back to the Basics – MedAssets

Medicare covers HCV screenings when conducted with the approved Food and
Drug …. diagnostic colonoscopy CPT 45378 in APC 0143. • The facility's wage
index = ….. Services (HHS) presented its budget for 2016 during a hearing of the
 …

UHC July 2015 Network Bulletin – UnitedHealthcareOnline.com

Jul 1, 2015 … ICD-10 Codes now Included in UnitedHealthcare's. Commercial … Medicare
Peer-to-Peer Process Change. •. Medicare …. 45378. Urologic Procedures.
50590. 52224. 52281. 52352. 52000. 52234 … 1, 2016 for River Valley members.
We …. Notification/Prior Authorization Table and CPT Code Crosswalk.

Physician-Related Services Provider Guide – Health Care Authority

Jan 1, 2016 … This publication takes effect January 1, 2016, and supersedes earlier …
Removed CPT codes and ICD codes … Added coverage requirements.

Preventive Services versus Diagnostic and/or … – Moda Health

Dec 16, 2015 … payment policy for covered medical and surgical services and supplies. Health ….
Medicare Advantage or Medicaid/EOCCO lines of business, … The following
additional CPT codes will be covered as noted above with a ….. 45378.
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without.

Blue Cross Medicare Advantage Section Of The Blues Provider

January 2016. Page S1. Table of …. emergency medical condition are covered by
Blue Cross Medicare … Copy both sides of the ID card and keep the copy with the
patient's file. …… GI Endoscopy – 45378 effective February 1, 2016. – Injection …

Add-On Codes Policy – Medicare – UHCCommunityPlan.com

Jul 8, 2015 … 2016R0071A … Terminology (CPT®*), Centers for Medicare and Medicaid
Services (CMS) or other coding guidelines. … the physician or other provider
contracts, the enrollee's benefit coverage documents, and/or other.

Medicare cost of colorectal cancer screening: CT … – Milliman

users to read, copy, distribute and make derivative works, as …. a diagnostic
colonoscopy CPT code accompanied by a diagnosis code … agents) are not
covered under Medicare Part A or Part B … 45378. Colonoscopy, flexible,
proximal to splenic flexure; diagnostic, with or …… to Part B for CY 2016;
Proposed Rule. Federal …

2016 HEDIS®/QRS/QARR/EES Physician Documentation …

2016 HEDIS®/QRS/QARR/EES Physician Documentation Guidelines and …
Participating provider and network agreements, as well as the member's
application for coverage … CPT: 44388-44394, 44397, 45355, 45378-45387,
45391, 45392 ….. This survey is developed by the Centers for Medicare and
Medicaid Services …

Provider Outreach Manual: Medicare Advantage Part … – Mercy Care

Medicare Advantage Part C STAR Measures www. ….. Provider and MCA
Focused 2016 Part C Star Ratings Measures. 2016 ID … CPT. HCPCS. ICD-9-CM
Procedure. 77055-77057. G0202, G0204, G0206. 87.36 ….. 45355, 45378-45387
,.

ASCA OPPS_ASC Payment Rule Comment Letter – nysaasc

Sep 2, 2014 … design fundamentals of Medicare's prospective payment system, an overly-rigid
… 45378) needs to be performed in the hospital – in emergent …. new rates in
2016. …. Changes to the list of ASC covered procedures. There are currently 359
CPT codes for which Medicare reimburses HOPDs but not ASCs.

AHA to CMS Re: Hospital OPP and ASC Payment Systems and …

Sep 6, 2013 … appreciates the opportunity to comment on the Centers for Medicare ….. That is,
while Medicare covers hospital outpatient therapeutic services as ….. For CY
2014, CMS proposes to assign all four CPT codes for proton …. code 45378,
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or.

Section 12, Part 2 – Fidelis Care

V16.0 – 1/4/2016. 12.2.1. The billing guidelines … Center for Medicare Services (
CMS), National Correct Coding Initiative (NCCI), National. Coverage …. in the
American Medical Association's (AMA) CPT Manual, National and Local
Coverage ….. 45378. Diagnostic colonoscopy. 45385. Lesion removal
colonoscopy. 45384.

3rd Quarter 2015 – Blue Cross and Blue Shield of Louisiana

Sep 30, 2015 … Pinnacle Medicare Services and senior provider relations analyst for. Unisys,
Louisiana … 2016. These members will utilize the behavioral health providers in
their … (45378) was converted to a polypectomy … of new 2015 CPT and HCPCS
codes. As …. page and indicate Blue Cross' coverage as follows:.

Ambulatory Surgery Center (ASC) Prospective Payment System …

Nov 1, 2011 … furnished to Medicare beneficiaries in ambulatory surgical centers (ASCs) …
beginning in CY 2013 for the CY 2015 and CY 2016 payment … Update to the
Lists of ASC-Covered Surgical Procedures. …. for substantial changes, such as
changes to ICD-9, CPT, National … 45378 Diagnostic colonoscopy.

HealthFirst Response, Physician Practice Reimbursement Report

Commercial Payers. Medicare. Medicaid. Facility Fees. Commercial Payers.
Medicare. Medicaid … 3. CPT Code. Specialty. Ind. Physician. Academic.
Hospital. VAR %. 45378 … Patients in universal coverage, low-cost systems with
equal …

Third Party Payer Q and A – wmgma

there is an E/M code for online visits, there is not a CPT code that defines an E/M
service being … However, this is non-covered for both Commercial and Medicare.
… 2016 and we will send out update when decision has been made. ….. modifier
52 or would it be appropriate to report CPT 45378 – Colonoscopy, flexible; …

New Affordable Care Act (ACA) Medical … – Premera Blue Cross

1, 2016, Premera will launch a new PersonalCare Partner Systems network that
will support … A PersonalCare Partner is a contracted ACO provider included in
the ….. Blue Cross Medicare Advantage Plan has engaged the services of Matrix
….. Providers should use modifier 33 with a CPT code for a service performed as
a …

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