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Fication to Providers of Centralized Influenza and Pneumococcal Vaccination Billing In order to notify multi-state mass immunizers about the availability of the centralized billing program for the 2001-2002 flu and pneumonia season, carriers should post the following notice on their web sites. Questions from interested providers should be forwarded to the designated processing carrier or to the central office address below. The Texas site for TrailBlazer Health Enterprises is the current proces.
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NM108 FAQ
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Prolonged services codes can be billed only if the total duration of all physician or qualified NPP direct face-to-face service (including the visit) equals or exceeds the threshold time for the evaluation and management service the physician or qualified NPP provided (typical/average time associated with the CPT E/M ...
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Direct Supervision - in the office setting means the physician (or other supervising practitioner) must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure.
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A change request in ACO-MS refers to adding new information or changing existing information in ACO-MS that may require CMS approval.
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Prolonged services with or without direct patient contact on the date of an evaluation and management (E/M) service have two codes: 99417 and 99418.
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Other Prolonged Services CPT / HCPCS Code(s)Time Threshold to Report Prolonged 99345 x 1 and G0318 x 1 Home or Residence visit, New patient 140 minutes 99350 x 1 and G0318 x 1 Home or Residence visit, Established patient 110 minutes 99483 x 1 and G2212 x 1 Cognitive Assessment and Care Planning 100 minutes7 more rows • Dec 9, 2023
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CMS Program Transmittal refers to a communication document issued by the Centers for Medicare and Medicaid Services (CMS) to provide guidance and instructions to Medicare Administrative Contractors (MACs), fiscal intermediaries, and other healthcare providers regarding changes, updates, and clarifications related to ...
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Prolonged services can be reported when time is used to select visit level, and the total practitioner time for the highest-level visit is exceeded by 15 or more minutes for services that are medically reasonable and necessary.
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Prolong Service Codes 99415, 99416 These codes are used when an evaluation and management (E/M) service is provided in the office or outpatient setting that involves prolonged clinical staff face-to-face time with the patient and/or family/caregiver.
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