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Posts tagged: 45378

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 …

45378 and 45384

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By , March 29, 2016 5:36 am

45378 and 45384

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ASC – American Society of Cataract and Refractive Surgery

Apr 1, 2014 … For the CY 2016 payment determination, the previously adopted claims-based
and … CY 2016. ASC-6: Safe Surgery Checklist Use. January 1, 2014 thru ,
December 31, 2014 ( …… 45383, 45384, 45385, 46221 …. CPT or HCPCS: 44388
, 44389, 44392, 44393, 44394, 45355, 45378, 45380, 45381,. 45383 …

FY 2016 MCRCEDP Unit Cost Reimbursement Rate Schedule

Jul 17, 2015 … colon decompression. Provider/Surgeon. 45378. ASC 45378-SG … cautery.
Provider/Surgeon. 45384. ASC 45384-SG. Hospital/Facility. **.

Section 11: Billing Requirements – PacificSource

Revised January 1, 2016. …… Example 1: The procedures performed are 45378 (
B), 45385, and 45380 and are based on 2009 Fully Implemented Facility RVUs.

2016_PQRS_Measure_439_11_17_2015.pdf – MDinteractive

Nov 17, 2015 … 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: … during the reporting
period (CPT or HCPCS): 45378, 45380, 45381, 45384, 45385,.

Preventive Care Services Coding Summary – Oxford Health Plans

Effective January 1, 2016 p. 1 of 18. Coding Summary for Providers ….. 45346,
45378, 45380, 45381, 45384, 45385, 45388 82270, 82274. Code Group 3 …

CMS Manual System – Centers for Medicare & Medicaid Services

Jan 1, 2006 … 45345, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, 45385,
45386, 45387, 45391, 45392, 47011,. 48511, 49021, 49041 …

American College of Gastroenterology – Policy and Medicine

Sep 2, 2014 … 2016. As our societies have stated in previous comment letters, …. time from the
previous review of colonoscopy base code 45378 ….. 45384 – Colonoscopy,
flexible, proximal to splenic flexure; with removal of tumor(s),.

HFHP Billing Guideline for Preventive Services (January 2016)

Jan 1, 2013 … 45378. Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or
without collection of specimen(s) by brushing or washing, with or.

CY 2016 Medicare Physician Fee Schedule Final Rule – AAMC

Dec 3, 2015 … Medicare Physician Fee Schedule Final Rule CY2016 … Payment update for
2016 (Conversion factor). • Estimate of RVU …… 45378 Diagnostic colonoscopy.
3.69. 6.19 … 45384 Colonoscopy w/lesion removal. 4.69. 7.76.

here – McKesson

Aug 18, 2015 … Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2016. …… 45347.
45349. 45350. 45378. 45379. 45380. 45381. 45382. 45384.

D. Higher Certificate in Theology – Theological Education by …

45378. Christian Proclamation: Preaching. Elective. 12. 45379. Introduction to ….
45384. -. 15 Apr 2016 17 Jun 2016. Second Semester. The second semester …

Programa de cursos en línea – Recinto de Guayama – Universidad …

30 Oct 2015 … Término de enero – mayo 2016 – (2016-30). DEPARTAMENTO … 43381. 37711.
37712. 45371. 45372. 35370. 45374. 45378. 45384. 60498.

(ASC) Prospective Payment System: 2012 Final Rule

Nov 1, 2011 … beginning in CY 2013 for the CY 2015 and CY 2016 payment determinations —
one … reporting in CY 2014 for the CY 2016 payment determinations. …. 45378
Diagnostic colonoscopy … 45384 Lesion remove colonoscopy.

Ambulatory Surgical Center Quality Reporting Program – Medical …

CY 2016 payment determination, the same claims-based and structural
measures as adopted … CY 2016. The establishment of quality measure
reporting procedures for …… 44361, 45330, 45331, 45378, 45380,. 45381, 45383
, 45384, 45385.

2016 Provider Reimbursement Manual – MDwise

Jan 1, 2014 … Page 2 of 266. Modified on December 28, 2015. MDwise Marketplace
Reimbursement Manual. Contents. Introduction .

Section 12, Part 2 – Fidelis Care

V16.0 – 1/4/2016. 12.2.1. The billing … 1/1/2016: Defined as On. Campus …..
45378. Diagnostic colonoscopy. 45385. Lesion removal colonoscopy. 45384.

Download the PDF – Milliman

45378. Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or
without collection of … Maybeb. Always. 45384. Colonoscopy, with removal of
tumor(s), polyp(s), or other lesion(s) …… to Part B for CY 2016; Proposed Rule.
Federal …

COA Winter Intersession Course Listing – College of Alameda

15, 2016. WINTER ONLINE INTERSESSION COURSE OFFERINGS … LORETTO
, E. 45378. HIST 7B*. HISTORY/U.S. SINCE 1865. SANCERI, J. 45386.

Adverse Events After Outpatient Colonoscopy in the Medicare …

Jun 16, 2009 … … 2009 Annals of Internal Medicine Volume 150 • Number 12 849. Downloaded
From: http://annals.org/ by a Googlebot User on 01/05/2016 …

Colorectal Cancer Screening – Passport Health Plan

HEDIS 2016 Technical Specifications. HEDIS is a … 45378. Colonoscopy. CPT
. 45379. Colonoscopy. CPT. 45380. Colonoscopy. CPT. 45381 … 45384.
Colonoscopy. CPT. 45385. Colonoscopy. CPT. 45386. Colonoscopy. CPT.
45387.

45378 screening

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By , March 25, 2016 11:59 am

45378 screening

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Coding Summary for Providers – UnitedHealthcareOnline.com

Effective January 1, 2016 p. 1 of 19. Coding … Deficiency. Anemia Screening …..
Screening. Fecal Occult Blood Testing, Sigmoidoscopy, or Colonoscopy: …
45346, 45378, 45380, 45381, 45384, 45385, 45388 82270, 82274. Code Group
3 …

HEDIS Measures 2016

Nov 5, 2015 … 2016 HEDIS® & Quality Assurance Reporting Requirements Measures. Provider
… 44397, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384,. 45385 …
Diabetic Retinal Screening with Eye Care Professional CPT II:.

Preventive Services versus Diagnostic and/or … – Moda Health

Dec 16, 2015 … Routine, in insurance terms, is synonymous with screening or preventative. … the
testing or care is considered a medical standard of care for the ….. 45378.
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with …. Official ICD-
10-CM Guidelines for Coding and Reporting, §IV, G. ICD-9-CM 2016.

Coverage Of Colonoscopies Under The Affordable Care Act's

use of proven colorectal cancer screening tests among the entire population ….
The most notable example of this is screening colonoscopy (code 45378),.

Summary of the 2016 MPFS Proposed Rule

Sep 8, 2015 … For CY 2016, CMS has incorporated the available utilization data ….. misvalued
codes, identified using the high expenditure screen under the ….. CPT code
45378 reported with the -53 modifier will now describe a more …

FY 2016 MCRCEDP Unit Cost Reimbursement Rate Schedule

Jul 17, 2015 … colon decompression. Provider/Surgeon. 45378. ASC 45378-SG … Colorectal
cancer screening; colonoscopy on individual at increased risk.

HEDIS measure: Colorectal Cancer Screening – Blue Cross and …

Cancer Screening. For adults … screening because it is not specific or
comprehensive enough to screen for … 45355, 45378-45387,. 45391 … the
NCQA link to obtain detailed information on 2015 – 2016 technical specifications
and data sets:.

Download the PDF – DHPA

Sep 8, 2015 … to Part B for Calendar Year 2016 (CY 2016) Proposed Rule (CMS-1631- … have
on colorectal cancer screening in the Medicare population as well as …. utilized
colonoscopy codes – specifically, 45378 (Colonoscopy, flexible …

here – McKesson

Aug 18, 2015 … Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2016. This year ….
radiation therapy centers, and independent diagnostic testing facilities.6 …..
45378. 45379. 45380. 45381. 45382. 45384. 45385. 45386. 45388.

HFHP Billing Guideline for Preventive Services (January 2016)

Jan 1, 2013 … Preventive care and screenings for women, infants, children, and …… 45378.
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with …

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

Sep 30, 2015 … 2016. These members will utilize the behavioral health providers in their own
network. FEP members … screening colonoscopy becomes diagnostic or
therapeutic. For Blue … (45378) was converted to a polypectomy. (45383).

here. – Palmetto GBA

Dec 10, 2015 … Reporting of Type of Bill (TOB) 014x for Billing Screening of … Ambulance
Inflation Factor for CY 2016 and Productivity Adjustment …………….11 ….. values
for Current Procedural Terminology (CPT) codes 44388-53; 45378-53;.

TPA-PREVENTIVE SERVICE LISTING Fiscal Year 2015-2016

Oct 1, 2015 … FY 2015/2016. Preventive Service: … aneurysm screening: men. The USPSTF
recommends one-time ….. 45330,45378,. 45380,. 45385,74263,.

2015-2016 Maximum Reimbursement Rates

Apr 1, 2015 … 4/1/2015 – 3/31/2016. Maximum … Screening mammogram – bilateral diagnostic
(film or digital). 77056 … 45378 or G0121 or G0105. $ 365.45.

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

getting a regular doctor's checkup and appropriate preventive screenings to
maintain good health. … 1, 2016, Premera will launch a new PersonalCare
Partner Systems network that will support our new …… Procedure code 45378 or
G0121.

Section 11: Billing Requirements – PacificSource

screening tests for genetic disorders, visits for unrelated ….. Example 1: The
procedures performed are 45378 (B), 45385, and 45380 and are based on 2009
 …

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 … Federally
required preventive services and screenings provided to women ….. For
procedures codes 45378, G0105, and G0121 submitted with a -53.

ASC – American Society of Cataract and Refractive Surgery

Apr 1, 2014 … For the CY 2016 payment determination, the previously adopted … CY 2016.
ASC-6: Safe Surgery Checklist Use. January 1, 2014 thru …… aged 50 years and
older receiving a screening colonoscopy without biopsy … CPT or HCPCS:
44388, 44389, 44392, 44393, 44394, 45355, 45378, 45380, 45381,.

EmblemHealth Provider Manual

Dec 31, 2015 … Last Updated: 01/07/2016. 2 ….. Empire BCBS. Effective January 1, 2016,
utilization …. We ask our PCPs to screen their patients for depression …

2015 HEDIS Provider Training – Clear Health Alliance

COL- Colorectal Cancer Screening. (Medicare). CPT: 82270, 82274, 45330-
45335,. 45337-45342, 45345 , 44388-. 44394, 44397, 45355, 45378-. 45387 …

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