Search results with tag "Moda health"
Gynecologic or Annual Women’s Exam Visit & Use …
www.modahealth.comCoding for the annual women’s exam differs for a Medicare Advantage plan versus a Moda Health Commercial health plan. A. For Moda Health Medicare Advantage plans: ... Gynecologic or Annual Women’s Exam …
Abdominoplasty/Panniculectomy - Moda Health — …
www.modahealth.comModa Health Medical Necessity Criteria Abdominoplasty - Panniculectomy Page 2/4 d. Abdominoplasty is NOT included and is NOT covered as it is considered cosmetic by Moda
Modifiers GA, GX, GY, and GZ - Moda Health — Provider of ...
www.modahealth.comPage 6 of 11 2. Moda Health. ABN Provider Notification Letter. March 31, 2015. See Attachment 2 at end of this list. 3. MS. “Advance eneficiary Notice of Noncoverage (AN) .”
Critical Care, Evaluation and Management ... - Moda Health
www.modahealth.comModa Health Reimbursement Policy is not intended to impact care decisions or medical practice. Providers are responsible for accurately, completely, and legibly documenting the services performed. Billed codes shall be fully supported in the medical record and/or office notes. Providers are expected
101 Low-cost ideas for worksite wellness - Moda Health
www.modahealth.com(Exercise and good nutrition are great stress-busters.) 48. Offer chair massages at health fairs. 49. Take stress relief breaks (i.e., meditation, walking or just closing the office door). Encourage employees to take time for themselves. 50. Suggest that employees volunteer to take a pet from a shelter for a walk.
Policy Title: Modifiers PO & PN for G0463 Clinic Visit ...
www.modahealth.comPolicy Manual, CCI table edits and other CMS guidelines). Benefit determinations will be based on the member’s medical benefit plan. Should there be any conflicts between the Moda Health Reimbursement Policy and the member’s medical benefit plan, the member’s medical benefit plan will prevail.
Clinic Services In the Hospital Outpatient Setting ...
www.modahealth.comFor clinic visits and services performed in the hospital outpatient setting, Moda Health does not allow split-billing of Provider- based clinic services as allowed by CMS for its Original Medicare business. This applies whether the clinic is located in an on campus-outpatient hospital setting (POS 22), an or off
Anesthesia Physical Status Modifiers (P1 - Moda Health
www.modahealth.com“The physical status modifiers identify levels of complexity of the anesthesia services, and are reported in conjunction with anesthesia services codes when appropriate. Physical status modifiers are represented by the initial letter "P" followed by the appropriate single digit from 1 to 6 (see the following list).
How to read an EOB - Moda Health — Provider of Group …
www.modahealth.comSample of an EOB Benefit paid to provider: The total dollar amount paid to the provider for the services rendered. Claim: The claim number generated by our system.
Qualifying Circumstances for Anesthesia - Moda Health
www.modahealth.comcircumstances would be reported as additional procedure numbers qualifying an anesthesia procedure or service. More than one code in the section may be selected, if applicable.
Extracorporeal Shock Wave Therapy - Moda Health
www.modahealth.com0102T Extracorporeal shock wave therapy performed by a physician, requiring anesthesia other than local, involving lateral humeral epicondyle 28890 Extracorporeal shock wave therapy, high energy; involving the plantar fascia 0299T, 0300T Extracorporeal shock wave therapy for integumentary wound healing, high energy V. References 1.
Modifiers XE, XS, XP, XU, and 59 - Moda Health
www.modahealth.comDec 07, 2020 · CPT Code 76000-XU – Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy) XU •CPT code 76000 should not be reported and Modifiers 59 or – X{EPSU} should not be used for fluoroscopy that is used in conjunction with a • Modifier –XU may be reported with code 76000 if the ...
Hospital Routine Supplies and Services - Moda Health
www.modahealth.comReimbursement Guidelines . Correct coding and code definitions apply in all circumstances and to all provider types. Whenever ... • Items used to obtain a specimen or complete a diagnostic or therapeutic procedure (DeWald: 17) ... Ultrasound guidance for procedures .
2018 Dental plan benefit summary - Moda Health
www.modahealth.comThese benefits and Delta Dental of Oregon policies are subject to change in order to be compliant with state and federal guidelines. This is a summary of the dental plan benefits and is not a contract.
Preventive Services versus Diagnostic and/or Medical Services
www.modahealth.comThe codes and tests eligible for this additional screening coverage are determined by a Moda Health Medical Director and are listed below. NOTE: These tests are not eligible for the 100%, no-cost-share Affordable Care Act preventive benefit because they are not on the PPACA list of mandated preventive services.
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Gynecologic or Annual Women’s, Coding, Moda Health, Abdominoplasty/Panniculectomy, Abdominoplasty - Panniculectomy, Modifiers GA, GX, GY, and, Provider, List, Critical Care, Evaluation and Management, Moda Health Reimbursement, Cost ideas for worksite wellness, Busters, Policy, Based, Setting, Anesthesia Physical Status Modifiers, Physical status, How to read an EOB, Qualifying Circumstances for Anesthesia, Circumstances, Extracorporeal shock wave therapy, CPT code, Fluoroscopy, Code, Hospital Routine Supplies and Services, Reimbursement Guidelines, Diagnostic, Ultrasound, Preventive, Codes