Can a consulting psychiatrist and/or a psychologist bill HCPCS G0502, G0503 and G0504 for Psychiatric Collaborative Care Management (CoCM) services or is this for the patient's Primary Care Provider (PCP) only?Ī5. To see the patient first, the MLP must be certified, have their own Medicare Provider Transaction Access Number (PTAN) and would not bill as "incident to." Is a patient required to see an MD before he/she sees a mid-level provider (MLP) such as an Advanced Practice Nurse (APN)?Ī4.
"Non-myeloid" malignancies are defined as types of leukemia. These are different from the progenitor cells for lymphacytes. Used in this context, Myeloid refers to those malignancies derived from myeloblasts. How is non-myeloid defined? Does this include leukemia and all types of lymphoma? If a patient has a non-myeloid primary, such as breast or prostate cancer, but also has metastasis to the bone, do those diagnoses meet the policy criteria?Ī3. If this is billed by a pharmacy, in order to replenish the patient's home supply, then use the date of delivery. Providers should use the actual date the drug was administered if delivered within a facility or "incident to" a physician's service.
For Factor Eight (VIII) drugs narrative, should a provider use the date of delivery or the actual date of service (DOS)?Ī2. CPTs 9596 are both attended studies and used for recordings in which interpretations can be made throughout the recording time, with interventions to alter or end the recording or to alter the patient care during the recordings as needed. See the CMS National Coverage Determination (NCD) Ambulatory EEG Monitoring (160.22). CPT 95953 is unattended: "…leads are placed and the patient is sent home…". When billing for Ambulatory Electroencephalogram or EEG with video, should CPT 95951 or CPT 95953 be billed?Ī1.