HCR/220–Week Six Checkpoint–Applying Level II HCPCS Modifiers * Apply the appropriate Level II HCPCS code modifier for each of the following examples. Explain your rationale. a) Portable home oxygen unit-GY – identifies rental or purchase of durable medical equipment for use in the patient’s home; is statutorily excluded‚ does not meet the definition of any Medicare benefit or for non-Medicare insurers‚ is not a contract benefit‚ is appended to procedures that are excluded from the Medicare
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artery –RC I chose this HCPCS Modifier Code because the procedure was performed on the right artery. B. Emergency ambulance transport and extended life support provided directly by provider of service –QN This code was chosen because emergency ambulance transport and extended life support was furnished directly by a provider of services‚ for example‚ a volunteer ambulance service. C. Diagnostic mammogram following screening mammogram‚ same patient –GG This modifier code was chosen because
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Applying Level II HCPCS Modifiers Shaunna Hardin March 16‚ 2011 HCR/220- Samantha Pinto Case | Code | Reason for choosing that code | Removal of chalazion (stye)‚ right eye‚ upper lid. | -E3 | I choose this because it describes where the stye was. | Arranged ambulance transport and extended life support | -QM | This code almost completely describes the medical scenario which is what the modifiers are supposed to do. | Diagnostic mammogram‚ left breast | -GG | This code refers to a mammogram
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Applying Level II HCPCS Modifiers 1) Portable home oxygen unit code = GM - I chose this code because due to the fact the physician prescribed this unit to the patient. 2) Emergency ambulance transport and extended life support code = QN – This code was chosen due to the fact that the ambulance services is one provided directly by the provider of service. 3) Diagnostic mammogram‚ left‚ code= GG – This code was chosen because it is used for performance and payment of screening mammogram and diagnostic
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patient to prepare for anything not covered by their provider. Using an inappropriate modifier or no modifier can cause the insurance provider to reject payment. This will cause the patient to stress and you to have more work going over the bill to ensure everything is completed properly. The easiest way to fix this issue is to know what codes you are working with and making sure you have the proper modifiers in place. If you are unsure‚ ask another person to help you. The national correct
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Checkpoint: Features of Health Plans There may be variations‚ but all insurance plans are one of two essential types; Indemnity or Managed Care (Valerius‚ Bayes‚ Newby‚ & Seggern‚ 2008). There are five health plans highlighted in this chapter; Indemnity Plans‚ Health Maintenance Plans (HMO’s)‚ Point of Service Plans (POS)‚ Preferred Provider Organization (PPO)‚ and Consumer Driven Health Plans (CDHP) (Valerius‚ Bayes‚ Newby‚ & Seggern‚ 2008). A short description and comparison is as follows:
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There are many different types of contraception available on the market today. Each type of contraception offers different advantages and disadvantages‚ and is not a one size fits all thing. Each person has different needs that need to be considered with choosing their birth control‚ and some people may choose to not be on any sort of birth control. Religion and differing views may also play a factor in choosing a type of birth control. Tina and Dan are a newly married couple who‚ prior to marriage
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Checkpoint: Medical Records Documentation and Billing Compliance plans are a process for finding‚ correcting‚ and preventing illegal medical office procedures (Valerius‚ Bayes‚ Newby‚ & Seggern‚ 2008). Therefore; all steps in the medical billing process correctly carried out‚ would apply as part of a compliance plan. In order to prevent illegal medical office practices‚ every step should be carried out as it was designed. In collecting accurate demographic and insurance information in step
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two types of Modifier problems: Misplaced and Dangling modifiers. Know what the modifier refers to. Make sure there is a word or word group in the sentence for the modifier to apply to. Place the modifier in the sentence as close as possible to the word or word group it refers to. (Target) Review There are two types of Modifier problems: Misplaced and Dangling modifiers. Know what the modifier refers to. Make sure there is a word or word group in the sentence for the modifier to apply to
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Shari Bratcher Week 7 – CheckPoint - Briefly Applying a Decision-Making Framework Anne Distagne‚ the CEO of Linkage Construction‚ Inc. is the involved stakeholder in this case. She was the person involved in the decision-making process of falsifying information to keep from displaying the significant increase in profit. There are several ethical issues involved. The first issue is Anne’s demeanor toward the accountant Sue. Anne used her superiority with Sue as a threat so that Sue can revise
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