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This policy describes Optum’s requirements for the reimbursement and documentation of “smoking and tobacco use cessation counseling visit” – CPT codes 99406 and 99407, and HCPCS procedure codes G0436 and G0437 .
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Patient Status Report (PSR) - Logon
www.myoptumhealthphysicalhealth.comOptumHealth Care Solutions – Physical Health includes OptumHealth Care Solutions, LLC, ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of …
Patient Status Report (PSR) - Logon
www.myoptumhealthphysicalhealth.comAs patients complete their treatment plans, providers and/or clinical staff record the patient’s final status using the final status categories on the report (note: MTB = maximum therapeutic benefit)
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Neck Index - OptumHealth Provider
www.myoptumhealthphysicalhealth.comNeck Index ACN Group, Inc. Use Onlyrev 3/27/2003 Patient Name Date This questionnaire will give your provider information about how your neck condition affects your everyday life.
PSF-750 Quick Reference Guide - OptumHealth …
www.myoptumhealthphysicalhealth.comOptumHealth Care Solutions – Physical Health includes OptumHealth Care Solutions, LLC, ACN Group IPA of New York, Inc., Managed Physical Network, Inc., and ACN Group of
1. Click the option Yes for Would you like to attach ...
www.myoptumhealthphysicalhealth.comHow to submit attachments to your Clinical Submission. 1. Click the option Yes for Would you like to attach additional documents 2. Attach documents …
Patient Summary Form - OptumHealth Provider
www.myoptumhealthphysicalhealth.comPost-surgical Diagnosis (ICD codes) Please ensure all digits are entered accurately Current Functional Measure Score Patient Summary Form PSF-750 (Rev: 7/1/2015)
NEW PATIENT VISIT CPT Code 99201 99202 99203 …
www.myoptumhealthphysicalhealth.comNEW PATIENT VISIT CPT Code 99201 99202 99203 99204 99205 Required Key Components *(3/3 required) History and Exam Problem-Focused X …
IMPORTANT NOTE ABOUT THIS REIMBURSEMENT …
www.myoptumhealthphysicalhealth.com3 98943), “The chiropractic manipulative treatment codes include a pre-manipulation patient assessment. Additional Evaluation and Management services may be reported separately using the modifier -25, if the patient’s condition requires a significant separately
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www.myoptumhealthphysicalhealth.com2 A modifier provides the means by which the reporting health care practitioner can indicate that a CPT descriptor code (service or procedure), which has been performed, has been altered by a specific circumstance or in some way without changing the
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