Examples of Procedure Codes in a sentence
Topic #11898 Advanced Life Support and Basic Life Support Procedure Codes Covered by ForwardHealth and Not Reimbursed by MTM Inc.Providers should submit claims with the following BLS (basic life support) and ALS (advanced life support) procedure codes to ForwardHealth, not to MTM Inc.
Currently, the following values are the minimum set of items being used for matching an encounter in the EODS:• Beneficiary Demographico Health Insurance Claim Number (HICN)o Name• Date of Service• Place of Service (2 digits)• Type of Service – not submitted on the 837-P, but is derived from data captured• Procedure Code(s) and 4 modifiers• Rendering Provider NPI• Paid Amount* * Paid Amount is the amount paid by the MAO or other entity and should be populated in Loop ID-2320, AMT02.
Topic #2481 Procedure Codes and ModifiersPersonal Care ServicesPersonal care providers are required to use the appropriate CPT (Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) procedure code from the following table that describes the service performed.
Listing Procedure Codes Approved as a Group on the Decision Notice LetterIn certain circumstances, ForwardHealth will approve a PA request for a group of procedure codes with a total quantity approved for the entire group.
The examples in this section illustrate the reporting of Paid Procedure Codes and Secondary Procedure Codes.
Currently, the following values are the minimum set of items used for matching an encounter in the EODS: • Beneficiary Demographico Health Insurance Claim Number (HICN)o Name• Date of Service• Type of Bill (TOB)• Revenue Code(s)• Procedure Code(s) and 4 modifiers• Billing Provider NPI• Paid Amount* * Paid Amount is the amount paid by the MAO or other entity and should be populated in Loop ID-2320, AMT02.
The most recent edition of the manual published by the American Dental Association (ADA) entitled “Current Dental Terminology and Procedure Codes (CDT)” is used when classifying dental services.
Currently, the following values are the minimum set of items used for matching an encounter in the EODS: • Beneficiary Demographico Health Insurance Claim Number (HICN)o Name• Date of Service• Place of Service (2 digits)• Type of Service – not submitted on the 837-P but is derived from data captured• Procedure Code(s) and 4 modifiers• Rendering Provider NPI• Paid Amount* * Paid Amount is the amount paid by the MAO or other entity and should be populated in Loop ID-2320, AMT02.
Procedure Codes and Modifiers Use of the modifiers in this section apply to both major procedures with a 90-day postoperative period and minor procedures with a 10-day postoperative period (and/or a zero day postoperative period in the case of modifiers “-22” and “-25”).
Note that periodontal cleanings, Procedure Codes that include periodonotal cleanings, and full mouth debridement are covered as a Basic Benefit, and routine cleanings are covered as a Diagnostic and Preventive Benefit.