'Insizakalo Yezinqubo Ezihlukile' Kuhlanganisa 4 Izinguquko

I-Modifier engu-59 yingu-modifier ekhethiwe ukukhomba izinsizakalo noma izinqubo ezenziwe ngosuku olufanayo njengesevisi ehlukile yezinqubo ngenxa yezimo ezikhethekile lapho lezi zinsizakalo noma izinqubo zingavamile ukubikwa ndawonye. Ngokujwayelekile, i-modifier 59 ingeziwe kumakhodi we-HCPCS / CPT uma ifomu lokumangala libonisa izinqubo ezimbili noma eziningi ezihlukene ezenziwa izingxenye zomzimba, izitho, noma indawo emelekile noma ukuhlangana okuhlukile ngosuku olufanayo lomsebenzi udokotela ofanayo.

I-CMS isebenzisa ama- modifiers amane athatha indawo ye-modifier 59 ezimweni ezithile. Ngokusho kwe-CMS, i-modifier 59 ingu-modifier esetshenzisiwe kakhulu kunazo zonke kanye ne-modifier engasetshenzisiwe kakhulu. I-Modifier engu-59 ibe yimbangela yezicwaningomabhuku zokuhlinzeka, izibuyekezo, izikhalazo, nobugebengu nokuhlukumeza amacala ngenxa yokusetshenziswa okungalungile.

Nakuba i-CMS iqhubeka nokuvuma nokuvuma ukusetshenziswa kwe-modifier 59, yengeze ama-subsets amane engeziwe we-modifier 59 e-Januwari 1, 2015. Lawa ma-subset ahlinzeka ngesizathu esicacile noma esichazayo esitholakala ukukhetha kuso.

• XE Ukuhlangana Okuhlukile
• Isakhiwo se-XS esihlukile
• I-XP Ohlukile Osebenzayo
• I-XU Isevisi Engavamile Yokuqeda

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I-Modifier XE: Ukuhlangana okuhlukile

I-Modifier XE: Ukuhlangana okuhlukile

Incazelo: Isevisi ehlukile ngoba kwenzeka ngesikhathi sokuhlangana okuhlukile.

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I-XS yokuhlela: Isakhiwo esihlukile

I-XS yokuhlela: Isakhiwo esihlukile

Incazelo: insizakalo ehlukile ngoba yenziwe ngegciwane / isakhiwo esihlukile.

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Umhleli we-XP: Umsebenzi ohlukile

Umhleli we-XP: Umsebenzi ohlukile

Incazelo: insizakalo ehlukile ngoba yenziwa ngudokotela ohlukile.

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Isihleli se-XU: Isevisi engavamile yokungaqedi

Isihleli se-XU: Isevisi engavamile yokungaqedi

Incazelo: ukusetshenziswa kwe-service okuhlukile ngoba ayihambanga izingxenye ezivamile zenkonzo esemqoka.

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I-Modifier 59: Insizakalo Yezinqubo Ezihlukile

I-Modifier 59: Insizakalo Yezinqubo Ezihlukile

Incazelo: Isamukelekile ngaphandle kwezimo lapho i-modifier ecacile ekhona khona

Ngaphezu kwalokho, akufanele kube kuhle ukusebenzisa i-modifier 59 kanye namanye ama-modifiers. Ukusetshenziswa okufanele kwe-modifier 59 kufanele kunqunywe ngokuchaza inqubo ye-NCCI yokuhlela inqubo yokubheka ngokuvakashela i-www.cms.gov/Medicare.

Okuningi

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Ukuhlelwa kweNqubo yeNqubo ye-NCCI

Inqubo ye-NCCI yokuhlela-kuya-inqubo ivimbela ukubika nokukhokhwa kwezinsizakalo ezingafanele zikhokhiswe ngokumangalelwa ndawonye. Ukuhlela kwe-NCCI kungatholakala kumatafula amane anikezwe kwiwebsite ye-CMS.

Lezi zibhebhe zibhekisela kwezibhedlela kanye nodokotela ukuze babone amasethi amakhodi angenakuthunyelwa ngesimangalo esifanayo noma ahlangane ngokuhlanganyela. Uma isimangalo sinamakhodi womabili, kunezinto ezimbili ezingenzeka:

1. Ngokusekelwe ukuthi ikhodi ihlelwe kukholomu 1 noma ikholomu 2 etafuleni, ikhodi yesibili ikholomu izophika. Isibonelo: Umhlinzeki akufanele abike ukuxilongwa okungaxhunyiwe kokunye kokuhlolwa kokutholwa komzimba nge-macmatic diagnostic mammogram. I-mammogram engaxhunyiwe ekuhlanganyeleni ngeke ikwazi ukukhokha.
2. Uma ithebula libonisa ukuthi kukhona ishintsho esifanele emitholampilo futhi isilungisi sisetshenzisiwe, kokubili amakholomu azofaneleka. Isibonelo: Sebenzisa i-Modifier 59 ngenqubo yesibili, eyengeziwe noma encane njengoba ibhalwe ohlwini lwekholomu 1 noma ikholomu 2 njengoba kufanelekile.