Revenant health Care | Medical Billing and Coding Services US

It is common for hospitalists to have advance care planning discussions and address advance directives with patients (and families) during an admission for a serious life-threatening condition or end-stage chronic disease. Medicare waives the coinsurance and the Medicare Part B deductible for ACP when: ● Provided on the same day as a covered AWV ● Furnished by the same provider as a covered AWV ● Billed with modifier –33 (Preventive Services) Voluntary ACP is considered a preventive service when billed with the AWV on the same day by the same provider, so CMS waives the deductible and coinsurance for ACP. When AWV is medically necessary and billed with ACP, but the AWV is denied for exceeding the once-per-year limit, payment can still be made for the ACP. In that case, CMS applies the deductible and coinsurance to the ACP service. The deductible and coinsurance DOES apply when ACP is provided outside the covered AWV. NOTE: Critical Access Hospitals (CAHs) may bill for ...

For assistant-at-surgery services performed by physicians , the fee schedule amount equals 16 percent of the amount otherwise applicable for the surgical payment. MACs may not pay assistants-at-surgery for surgical procedures in which a physician is used as an assistant at-surgery in fewer than five percent of the cases for that procedure nationally. This is determined through manual reviews. Procedures billed with the assistant-at-surgery physician modifiers “-80” (Assistant Surgeon), “-81” (Minimum assistant surgeon), “-82” (Assistant surgeon (when qualified resident surgeon not available)), or the AS modifier (physician assistants, nurse practitioners and clinical nurse specialists), are subject to the assistant-at surgery policy. Accordingly, Medicare pays claims for procedures with these modifiers only if the services of an assistant-at-surgery are authorized. Medicare’s policies on billing patients in excess of the Medicare allowed amount apply to assistant-at-surger...