What is a mutually exclusive CPT code?

What is a mutually exclusive CPT code?

CPT codes 99050 and 99051 are considered mutually exclusive to any service(s) provided at an urgent care center.

Is CPT 99499 covered by Medicare?

For evaluation or re-evaluation services, physical and occupational therapists will not be reimbursed for E/M (CPT codes 99201-99499). Consistent with the coding guidelines from the Centers for Medicare and Medicaid Services (CMS), they will only be reimbursed for appropriate use of CPT codes 97001-97004.

How many units can you bill for G2212?

However, the DWC has adopted a Medically Unlikely Edit (MUE) limiting providers to 4 units of G2212 for dates of service on or after April 1, 2021. There is no limit to the number of billable G2212 units for dates of service from March 1 to March 31, 2021.

Does Medicare pay for prolonged services?

Finally, you should remember that Medicare contractors will not pay (nor can you bill the patient) for prolonged services codes 99358 and 99359, which do not require any direct patient F2F contact (e.g., telephone calls).

Can mutually exclusive procedures be billed together?

Mutually Exclusive Procedures Many procedure codes cannot be reported together because they are mutually exclusive of each other. Mutually exclusive procedures cannot reasonably be performed at the same anatomic site or same patient encounter.

Does CPT 92960 need a modifier?

There is a specific CPT code, 92960, for such cardioversions. There are no separate codes or modifiers for using paddles or hands-free, and there are no special codes or modifiers for biphasic cardioversion. CPT code 92960 is for elective cardioversion, not defibrillation. There is no separate code for defibrillation.

Is 92960 a surgical procedure?

CPT code 92960 describes a planned elective procedure. If a planned elective external cardioversion is performed by a provider/supplier reporting critical care time (CPT codes 99291, 99292), the time to perform the elective external cardioversion shall not be included in the critical care time.

What is the Mue for G2212?

Update as of 4/23/21: previously, there was no limit to the number of G2212 units providers could apply. However, the DWC has adopted a Medically Unlikely Edit (MUE) limiting providers to 4 units of G2212 for dates of service on or after April 1, 2021.

How do you bill for prolonged services?

The prolonged service code (99417) can be reported with 99205 when the total physician time exceeds the minimum time (60 minutes) for 99205 by at least 15 minutes. Thus, physician time, with and without patient contact, would need to be at least 75 minutes to report a prolonged service code.

What is the new prolonged service code for 2021?

2021 prolonged service changes. CPT 2021 assigns 60-74 minutes to 99205 for a new patient office visit and 40-54 minutes to 99215 for an established patient level five visit.

What is the difference between 51 and 59 modifier?

While modifier 51 and 59 both apply to additional procedures performed on the same date of service as the primary procedure, modifier 51 differs from modifier 59 in that it applies to procedures that may be more commonly expected to be performed during the same session.