Archive for The Day of April 26th, 2006

Archive for the Day of April 26th, 2006

Welcome to the medical billing blog archive for the day of April 26th, 2006.

Here you will find links to every article added to the Outsource Management Group web site during April 26th, 2006.

You can browse this day's archives by clicking the "More" button from any of the excerpts below.

Medicare-No Pay For Certain Gastric Procedures

If you are a physician that does regular gastric by-pass procedures, you need to know that as of March 17th, Medicare will no longer reimburse the code 37216 which is transcatheter placement of intracatheter stents according to their latest transmittal from the Centers for Medicare & Medicaid Services. Other changes that are coming soon will be to the physician reimbursement fee schedule. New medical billing claims need to show code 37216 to have the status code of “R,” and carriers should adjust their systems to “reflect a non-coverage status” for this particular code. Another change in the gastric medical billing category will be to restrictive procedure code 43842 that will

Watch Your Usage of Sedation Codes In Medical Billing

In the new 2006 release, CPT introduced six new codes for moderate sedation (99143-99150, Moderate (conscious) sedation) and the six new codes replaced the two previously used conscious sedation codes (99141-99142). For the moment, the six new codes have been assigned by Medicare a status of “C”, which means that the codes are carrier priced. In many instances carrier priced often means no reimbursement for the physician. Certain Medicaid programs will pay for moderate sedation for children. For example, if a child comes in with a high fever and the doctor suspects an illness like meningitis, the doctor may need to give the patient a spinal tap under moderate sedation

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