CLAIMS FILING REQUIREMENTS
Note: Physicians and suppliers who qualify for an exemption from the mandatory electronic claims submission requirements and who submit claims using the paper claim Form CMS-1500, must use Form CMS-1500 (08-05) beginning July 2, 2007.
Items 17 and 17a/17b
Enter the name and National Provider Identifier (NPI) of the ordering physician here. This is a required field for all diagnostic radiology claim submissions. If the name and NPI of the ordering physician is not entered, the claim will be rejected as unprocessable.
Item 19
Enter the NPI of the physician or supplier who is performing the technical or professional component of a diagnostic test that is subject to the anti-markup payment limitation.
Item 20
If any portion of the test was acquired and the anti-markup limitation applies, check the “Yes” box and enter the acquired price under Charges.
Item 32
Enter the complete name and physical address of the facility where the services are provided. This is a required field for all services provided in any place of service other than the patient’s home.
If billing for acquired services, also report the NPI of the entity that performed the test in Item 32.
Radiology billing and coding tips. Learn about radiology billing services health care CPT codes and reimbursement. How to do Radiology billing correctly. PET CT scan coding and Guidelines.
Thursday, April 28, 2011
Subscribe to:
Post Comments (Atom)
Most Read Radiology Billing Articles
-
Appropriate Procedure Codes Effective for PET Scans for Services Performed on or After January 28, 2005 All PET scan services require the...
-
Procedure code and Decription 20610 - Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacr...
-
PROCEDURE CODE AND Decription 76881 - Ultrasound, extremity, nonvascular, real-time with image documentation; complete - Average fee a...
-
Procedure code and Description Group 1 Codes: 51785 NEEDLE ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, ANY TECHNIQUE ...
-
PROCEDURE CODE and Description 71010 - Radiologic examination, chest; single view, frontal - Fee amount $20 - $26 71015 - Radiologic e...
-
RADIOLOGY PROCEDURE CODE EASY GUIDE FOR BONE DENSITY/DEXA/CAT SCAN BONE DENSITOMETRY/DEXA DEXA – hips, spine. . . . . . . . . . . . ....
-
Procedure CODE and description 77002 - Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization devic...
-
Procedure Code AND Description 76770 - Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; comple...
-
Ultrasound Frequency Limitations Reimbursement for the following Procedure-4 radiological ultrasound procedure codes is limited to four...
-
Procedure Code and description 76536 - Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with im...

No comments:
Post a Comment