After Hours and Weekend Care |
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Allergy Testing Immunotherapy |
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Ambulatory Surgical Groupers |
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Anesthesia Reimbursement Policy |
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Assistant at Surgery – Modifiers 80/81/82 and AS (Commercial) |
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Billing for Habilitative and Rehabilitative Services |
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Biomarkers Testing for Autoimmune Rheumatic Disease (LBM) |
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Bundled Services (Commercial and Medicare) |
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Coding Edits Policy (Commercial, Medicare, and Medicaid) |
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Colorectal Cancer (LBM) |
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Compression Garments |
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Computer Assisted Surgical Navigation |
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Coronavirus Testing in the Outpatient Setting (LBM) |
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Corrected Claim Submission |
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Co-Surgeon/Team Surgeon-Modifiers 62/66 |
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CPT and HCPCS Billing Guidelines |
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Daily Maximum Units (Commercial/Medicare) |
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Diagnosis Code Guidelines: Manifestation/Secondary Diagnosis Codes |
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Discarded Drugs/Biologicals – Modifier JW (Commercial) |
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Discontinued Procedures – Modifiers 53, 73 & 74 (Commercial) |
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DME In-Office/Non-Facility |
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DME Rental vs. Purchase |
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Drug Alcohol Testing (Commercial/Medicaid) |
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Drugs and Biologicals |
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Emergency Department Facility E&M Coding’ |
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Evaluation and Management (E&M) Services |
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Facility Fees for E&M Services on Outpatient Facility Claims |
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From/To Date Span |
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Hepatitis Testing (LBM) |
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Home Health Care Services |
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Hospital Readmissions |
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Human Immunodeficiency Virus (HIV) (LBM) |
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Intraoperative Neurophysiology Monitoring Services (IONM) |
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Laboratory/Venipuncture |
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Mid-Level Practitioner Reimbursement Policy (Commercial) |
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Modifier SU – Procedure Performed in Physician’s Office (Commercial) |
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Modifier Reference Policy |
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Modifiers PN & PO for Clinic Visit Services (G0463) – (Medicare) |
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Multiple & Bilateral Surgical Procedures Policy |
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Multiple Diagnostic Imaging Payment Reduction Policy (Commercial) |
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Multiple Procedure Reduction Cardiology/Ophthalmology |
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National Drug Code (NDC) Requirements for Drug Claims – Commercial, Medicare, and Medicaid |
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Never Events/Adverse Events & Serious Reportable Events (Commercial) |
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No Cost/Reduced Cost Drugs, Implants & Devices |
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Observation Stay - Commercial |
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Observation Stay – Medicare and Medicaid |
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Operating Microscope/Microsurgery (CPT 64727/69990) |
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Ophthalmology Reimbursement Policy |
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Outpatient Diagnostic Imaging Self-Referral Payment Policy |
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Preventive Care Services (Commercial) |
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Preventive Care Services (Medicare) |
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Preventive Medicine and Screening (Commercial) |
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Prolonged Services (Commercial, Medicare and Medicaid) |
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Radiology Cardiology Ultrasound Bundling Rules (Administered by EviCore) |
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Radiology Cardiology Ultrasound Frequency Rules (Administered by EviCore) |
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Radiology Cardiology Ultrasound Correct Coding Rules (Administered by EviCore) |
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Radiopharmaceuticals and Contrast Media |
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Revenue Codes Requiring Detailed Coding |
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Robotic Surgery |
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Routine Foot Care Services |
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Split Surgical Care (Modifiers 54/55/56) (Commercial) |
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Telehealth/Virtual Care Services |
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Treatment Room |
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Unlisted Codes |
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B-Hemolytic Streptococcus Testing (LBM) |
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Biochemical Markers of Alzheimer Disease and Dementia (LBM) |
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Bone Turnover Markers Testing (LBM) |
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Celiac Disease Testing (LBM) |
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Cervical Cancer Screening (LBM) |
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Diagnosis of Vaginitis (LBM) |
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Diagnostic Testing of Common Sexually Transmitted Infections (LBM) |
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Diagnostic Testing of Influenza (LBM) |
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Epithelial Cell Cytology in Breast Cancer Risk Assessment (LBM) |
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Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing (LBM) |
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Fecal Calprotectin Testing in Adults (LBM) |
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Flow Cytometry (LBM) |
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Folate Testing (LBM) |
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Gamma-Glutamyl Transferase (LBM) |
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General Inflammation Testing (LBM) |
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Helicobacter Pylori Testing (LBM) |
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Immunohistochemistry (LBM) |
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Immunopharmacologic Monitoring of Therapeutic Serum Antibodies (LBM) |
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In Vitro Chemoresistance and Chemosensitivity Assays (LBM) |
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Lyme Disease Testing (LBM) |
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Measurement of Thromboxane Metabolites for ASA Resistance (LBM) |
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Nerve Fiber Density Testing (LBM) |
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Onychomycosis Testing (LBM) |
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Oral Cancer Screening and Testing (LBM) |
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Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing (LBM) |
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Pediatric Preventive Screening (LBM) |
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Pharmacy Medical Claim Edit |
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Plasma HIV-1 and HIV-2 RNA Quantification for HIV Infection (LBM) |
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Prescription Medication and Illicit Drug Testing in Outpatient Setting (LBM) |
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Prostate Biopsy Specimen Analysis (LBM) |
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Salivary Hormone Testing (LBM) |
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Testing For Alpha-1 Antitrypsin Deficiency (LBM) |
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Testing for Diagnosis of Active or Latent Tuberculosis (LBM) |
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Testing for Vector-Borne Infections (LBM) |
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Testing of Homocysteine Metabolism-Related Conditions (LBM) |
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Testosterone Testing (LBM) |
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Thyroid Disease Testing (LBM) |
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Urine Culture Testing for Bacteria (LBM) |
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Vitamin B12 & Methylmalonic Acid Testing (LBM) |
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Vitamin D Testing (LBM) |
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Zika Virus Risk Assessment (LBM) |
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Allergen Testing (LBM) |
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Biomarkers for Myocardial Infarction and Chronic Heart Failure (LBM) |
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Cardiovascular Disease Risk Assessment (LBM) |
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Diabetes Mellitus Testing (LBM) |
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Diagnosis of Idiopathic Environmental Intolerance (LBM) |
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Diagnostic Testing of Iron Homeostasis & Metabolism (LBM) |
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Erectile Dysfunction (LBM) |
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Evaluation of Dry Eyes Testing (LBM) |
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Genetic Testing for Adolescent Idiopathic Scoliosis (LBM) |
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Identification of Microorganisms Using Nucleic Acid Probes (LBM) |
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Immune Cell Function Assay (LBM) |
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Intracellular Micronutrient Analysis (LBM) |
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Lab Testing for the Diagnosis of IBD (LBM) |
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Metabolite Markers of Thiopurines Testing (LBM) |
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Medicare Part D Vaccines |
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Pancreatic Enzyme Testing for Acute Pancreatitis (LBM) |
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Pathogen Panel Testing (LBM) |
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Prenatal Screening-Nongenetic (LBM) |
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Preventive Screening in Adults (LBM) |
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Prostate Specific Antigen (PSA) Testing (LBM) |
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Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease (LBM) |
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Serum Tumor Markers for Malignancies (LBM) |
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ST2 Assay for Chronic Heart Failure (LBM) |
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Split/Fragmented Billing |
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Urinary Tumor Markers for Bladder Cancer (LBM) |
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Vectra DA Blood Test for Rheumatoid Arthritis (LBM) |
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Venous Thrombosis Risk Testing (LBM) |
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