Transcription of Billing and Coding Guidelines - CMS
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Billing and Coding Guidelines - CMS
Billing and Coding Guidelines Contractor Name Wisconsin Physicians Service Insurance Corporation Title INJ- 018 botulinum Toxin Type A & Type B. Revision Effective Date 10/01/2011. AMA CPT/ ADA CDT Copyright Statement CPT codes, descriptions and other data only are copyright 2010 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply CMS Regulations: Title XVIII of the Social Security Act section 1862 (a)(1)(A). This section allows coverage and payment of those services that are considered to be medically reasonable and necessary.
Because Botulinum toxin type A is an expensive drug, CMS is encouraging providers to schedule patients in such a way that the drug may be used most efficiently. If a vial is split between patients, the billing in these instances must be for the exact amount of Botulinum toxin used on each individual patient, and a proportion of the wastage for
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