CPT code 87002, which refers to the culture of bacteria from a specimen, is typically covered by Medicare when medically necessary and performed in accordance with applicable guidelines. However, coverage can depend on specific circumstances, such as the patient's condition and the reason for the test. It's important for providers to check with Medicare or review their local coverage determinations for any specific requirements or limitations.
As of my last knowledge update in October 2023, the reimbursement rate for the CPT code 88305 (surgical pathology, gross and microscopic examination) can vary based on factors such as the specific Medicare Administrative Contractor (MAC) and local policies in Georgia. Typically, this code falls under the Medicare Physician Fee Schedule, and the reimbursement rates are subject to annual updates. To obtain the most current and specific reimbursement amount, it's recommended to consult the latest Medicare Fee Schedule or contact the local MAC for Georgia.
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yes
Belen, NM
Procedure code 36465 refers to the collection of venous blood by venipuncture. The Medicare allowable amount for this procedure can vary based on factors such as geographic location and specific Medicare plans. Generally, it is advisable to consult the latest Medicare fee schedule or contact Medicare directly for the most accurate and current reimbursement rates for this procedure.
No, the OmniPods and the OmniPod Personal Diabetes Manager are not currently covered by Medicare. Only traditional pumps are covered (such as Animas, MiniMed or Disetronic pumps). Those are cosidered durable medical equipment and utilize a different HCPCS code that is covered by Medicare.
The whopping cough needle is billed under code CPT 90715. Under Medicare it is not authorized for refund due to the vaccine containing acellular pertussis.
The physical exam (code 99397) has never been covered by Medicare. Further, the Medicare Annual Wellness Visit (AWV) services clearly do not include an exam.
Medicare Service Code 96402 refers to the administration of chemotherapy drugs via an injection or infusion, specifically for the treatment of cancer. This code is typically used for the administration of anti-neoplastic agents that are not self-administered. It is important for healthcare providers to document the procedure accurately to ensure proper billing and reimbursement.
Billing code A9270 refers to "non-covered items or services" in medical billing, which indicates that the service or item provided is not eligible for reimbursement by Medicare or other insurance providers. This code is often used for items that may be deemed experimental, cosmetic, or not medically necessary according to the payer's guidelines. Providers must inform patients that they may be responsible for the full cost of services billed under this code.
Medicare code 71010 refers to a diagnostic procedure known as a "Radiologic examination, chest, two views, frontal and lateral." This code is used for billing purposes when a chest X-ray is performed to evaluate conditions such as pneumonia, heart failure, or lung diseases. It is essential for healthcare providers to use this code correctly to ensure proper reimbursement for the services rendered.
CPT code 99397, which is for preventive medicine evaluations and management for patients aged 65 and older, is generally covered by Medicare as part of the Annual Wellness Visit (AWV). However, coverage can depend on specific circumstances and whether the visit meets Medicare's criteria for preventive services. It's advisable for providers to verify coverage details with Medicare directly or through their billing department to ensure any specific conditions are met.