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Tag Archives: Screening

Coding Hepatitis B Screening: How to Ensure Reimbursement

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Help your organization join the fight against Hepatitis B (HBV) infection by understanding what conditions are necessary for coverage of HBV screening and how to properly code the Hepatitis B surface antigen (HBsAg) serologic test. Here is a breakdown what you need to know when coding for HBV screening to ensure reimbursement. The article Stop Hepatitis […]

The post Coding Hepatitis B Screening: How to Ensure Reimbursement appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Stop Hepatitis B via HBsAg Screening in Pregnant Women

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Screening for Hepatitis B (HBV) infection in pregnant women provides substantial benefit, reaffirms the U.S. Preventive Services Task Force (USPSTF) in their recommendation statement released this month. This determination follows their review of new evidence on the benefits and risks of screening for hepatitis B surface antigen (HBsAg). Serologic testing accurately identifies HBV infection and, in turn, […]

The post Stop Hepatitis B via HBsAg Screening in Pregnant Women appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Screening and diagnostic mammography — retired Part A and Part B LCD

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LCD ID number: L36342 (Florida/Puerto Rico/U.S. Virgin Islands)

After review of the local coverage determination (LCD) for screening and diagnostic mammography, it was determined to retire the LCD based on national coverage determination (NCD) 220.4. 

Therefore, the related coding guideline article is also being retired.

Effective date:

The retirement of this LCD and related coding guideline article is effective for services rendered on or after July 31, 2019.

Click here for future and retired LCDs


Coding Ahead

Depression Screening Coding Guidelines – CPT G0444

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Reimbursement Guidelines for Depression Screening – CPT G0444


Depression screening CPT G0444 can’t be coded with CPT G0402 & G0438 but you may report with CPT G0439. NCCI edits stated as “Code G0444 is a column 2 code for G0402. You may not override the edit”.


Nationally Covered Indications:


CMS will cover annual screening up to 15 minutes for Medicare beneficiaries when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up. 
 
At a minimum level, staff assisted supports consist of clinical staff (e.g., physician assistant, nurse) in the primary care setting who can advise the physician of screening results and who can facilitate and coordinate referrals to mental health treatment. Services covered under this NCD must be provided by a primary care provider.


Nationally Non-Covered Indications:


Screening for depression is non-covered when performed more than one time in a 12-month period. Also self-help materials, telephone calls, and web-based counseling are not separately reimbursable by Medicare and are not part of this NCD.


Medicare coinsurance and Part B deductible are waived for this preventive service.


Place Of Service:


Effective for claims with dates of service on and after April 2, 2012, contractors shall pay for annual depression screening claims, G0444, only when services are provided at the following Places of Service (POS) 
 

11 Physician’s office
19 Off Campus-Outpatient hospital
22 On Campus-Outpatient hospital
49 Independent clinic 
71 State or local public health clinic


Coding Ahead

June 27th is National HIV Testing Day: Coding Fundamentals for HIV Screening

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Medicare covers annual HIV screening. It is important for providers to recommend HIV screening because early detection will help their patients live longer, healthier lives. Claims reimbursement for this preventative service is dependent on proper coding and a clear understanding of benefit limitations and requirements. Here’s what you need to know, especially in honor of […]

The post June 27th is National HIV Testing Day: Coding Fundamentals for HIV Screening appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Depression screening and treatment

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In the January edition of The Joint Commission Journal on Quality and Patient Safety, a study was published by Ann M. Schaeffer, DNP, CNM, and Diana Jolles, PhD, CNM, at the Harrisonburg Community Health Center (HCHC) in Virginia. Set in a diverse city in Virginia, researchers showcased ways to overcome cultural and language barriers to depression treatment.

HCPro.com – Briefings on Accreditation and Quality

Screening Diagnosis Code

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I work at a Urology office and we use Z12.5 (Encounter for screening for malignant neoplasm of prostate) when we draw a psa. The providers have been using this in their assessment and want to use this as a stable problem for 1 point. Can screening diagnosis codes be used at established problems if they are not really problems? Any advice would be greatly appreciated.

Medical Billing and Coding Forum

TOX Drug Screening Reimbursement

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I was wondering if anyone had any suggestions on how to get CPT 80306 and CPT 80307. I work in Worker’s Compensation so we provide a quantative range for the results. The tests need to be paid because they have been completed regardless if a patient is positive or negative. Certain companies pay in full, while others refuse to pay anything. Please provide any insight into how to appeal for payment. Thank you!

Medical Billing and Coding Forum

Maternal Mental Health Screening

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Good day, everyone.
I’ve current undertaken a new task of researching information that is not familiar to me. I’m hoping for anyone’s assistance, as I would be forever grateful for any little bit of help.
I’m looking for any guidelines for the screening of maternal mental health (postpartum depression) by either the OBGYN or pediatrician. My current focus is for the CA guidelines, however would appreciate for any location as I start to gather info. OBGYNs and pediatricians all recommend screening as a standard of care, and furthermore, the CA legislation requires OB’s to screen as of 7/1/19. I was hoping this would make things easier to locate the info, however I’m not sure if I’m just searching incorrectly or if the info just isn’t out there.
I need any information regarding any coding, billing and insurance reimbursement rates. We think we found the Medi-Cal codes and rates (Medicaid for CA – 50% of CA births) and we think we found the CPT and ICD-10 codes for private ins but this is only though fearless Googling and clicking around.

I do have some information gathered and would LOVE to discuss this with someone who might be familiar.

Thanks,
Kelly

Medical Billing and Coding Forum