May 1, 2013

Medicare coverage for Pap smear, Screening and Diagnostic

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Medicare provides coverage for both screening and Diagnostic Pap smear and correct way of billing and coding Pap smear depend upon choosing the right CPT code for Diagnostic and screening pap smear.

Medicare coverage for Pap smear, Screening and Diagnostic

Medicare coverage for Pap test

  • Covered in every 24 months for all female having no symptoms of illness.
  • Covered in every 12 months in case if patient has high risk for cervical or vaginal cancer, in childbearing age and had an abnormal Pap test in the past 36 months. Refer to the CMS National Coverage Determination (NCD) for high-risk criteria.

Screening Pap smears

When patient does not have signs and symptoms of cervical, uterine or vaginal cancer.
Use following HCPCS codes for screening Pap smear

G0123-G0124,
G0141-G0145,
G0147, G0148, P3000, P3001 and Q0091

Diagnostic Pap smears
When patient have an abnormal Pap smear or have signs or symptoms of cervical, uterine or vaginal cancer. Use following CPT codes for Diagnostic Pap smear billing and coding.

88141-88143
88147-88148
88150
88152-88155
88164-88167

Note: Medicare may deny coverage if Low or high risk case are not reported with appropriate Diagnosis code. So please also use appropriate ICD-9-CM Diagnosis Code
in above mentioned cases.

April 25, 2013

Psychology Billing Softwares Reviews for Mental Health Practices

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Reviews of best Psychology Billing Softwares that can effectively help Clinical Psychologists, Psychiatrist, Psychotherapist and Mental Health Practices for Medical Billing and Coding to optimize and maximize their Medical Insurance Claims Reimbursements.

Advanced technology research in the healthcare and medical field translates to efficient psychology billing software that enable mental health practitioners to manage their practices easily and efficiently.

Psychology Billing Software System are now commonly being used by mental practitioners to keep track of appointments, patients, treatments, case notes and billing claims.
Psychology Billing Softwares Reviews for Mental Health Practices

Best Psychology Billing Softwares

The following are some of the best Best Psychology Billing Softwares used by psychologists and psychiatrist in their day to day activities of billing and recording of patient data:
  1. Practice Suite Psychology Specialty

    This is a fully integrated mental health management and billing software that is extensively used by psychologists as it s designed to meet specific mental needs. This software automates all complete workflow from patients and all the billing processes. PractiseSuite is able to reduce redundancy in data entry between various billing and clinical processes. It is able to ensure all charges are correctly and accurately billed.


    Clinical documentation with PractiseSuite is as simple as it should be making it easy to install store and access data. Worth noting is that it is web based enabling one to access any data regardless of location as long as one has an internet connection. For more details, you can request a free Practice Suite demo.

  2. PsyQuel- Billing for Mental Health Providers

    This is a web based billing and collection service for mental health that is perfect for mental billing. It is perfect for pursuing any unpaid insurance claims while resolving any issues with denied insurance claims. PsyQuel is able to draft statements the same day a patient checks in

    PsyQuel allows for unlimited number of users and sites ones the software has been installed while ensuring secure storage of data; it also comes with backup for any stored records. Other things you can do with PsyQuel include creating appointment reminders and recording of clinical notes. For further details, you can request a free PsyQuel demo.

  3. QuickPractise

    QuickPractise mental billing software makes life easier by eliminating the repetitive paperwork thereby saving a lot on time. This is software that is sure to reduce cash flow nightmares while improving cash flow efficiency thereby increasing productivity and profits.

    QuickPractise is able to ensure medical offices get more without hiring more; it is able to scrutinize time consuming routine tasks. One thing worth noting is that QuickPractise reduces claim payment time from several months to between 7 and 14 days with the e-billing services. For further details, you can request a free QuickPractise trail download.

  4. CareCloud

    CareCloud mental health and billing software offers complete clinical, administrative and revenue cycle management solution just at the touch of a button. CareCloud integrates all essential aspects of behavioral health management in one easy to use package able to give providers a 360 degree view of the organization.


    Carecloud is also able to fasten the billing process by ensuring accurate recording of data essential for billing. It is also perfect for preparing insurance claims and able to reduce chances of denials. For further details, you can request a free CareCloud demo.

  5. ShrinkRapt

    This is one of the best selling and billing software for psychologists and psychiatrists. It is perfect for preparing client billing statements and the filling of the CMS 1500 insurance form. This software can also be used to keep track of all medications and summaries practice statistics.

    ShrinkRapt is an easy to install and use software you can ever find anywhere; it comes with a free technical support for as long as one needs help. For further details, you can request a free ShrinkRapt demo.

  6. SpectraSoft

    SpectraSoft makes is aimed at making any work related to behavioral health and Behavioral Analysis easy. It is responsible for keeping good track of all patients’ visits and keeping a secure record of all their details. SpectraSoft ensures billing the same day a patient visits while also pursuing any unpaid insurance claims.

    SpectraSoft is also efficient in resolving any denied insurance claims and perfect for posting all insurance payments and EOBS. For further details, you can request a free SpectraSoft demo.
Any mental health software should be able to handle activities such as patient records, billing and scheduling. Billing is essential to ensure all payments are made on time and reduce any chances of denial on claims from insurance companies.

April 21, 2013

Online Medical Billing Software Reviews

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Top 5 Best Online Medical Billing Software Reviews. Web based Medical Billing Softwares can be simply used through Internet Explorer, Chrome, FireFox, Safari or other browses, without any installation requirements.

Medical Billing and Coding Companies are increasing replacing traditional Billing Softwares with web-based online Medical Billing Systems. Medical Billing Business needs are highly very complicated now days. Thus, a best Medical Billing Software must an all-in-one system to simplify, accelerate, integrate and semi-automate the different functions of medical billing, coding and claim submission process, with accuracy and efficiently.
Online Medical Billing Software System

Web Based Medical Billing Software Benefits

  1. Access to Patient Information Anywhere

    Online medical billing software’s ensure ease of access of patient information, regardless of the location one is in, as compared to the traditional systems. By simply logging in from any PC with internet one can get the desired patient records.

  2. Fastest Once-For-All Setup

    Faster deployment is the other benefit that comes with an Online Medical Billing software, as one can sign up and start working immediately without any needs for downloading, installation and configuration.

  3. Lowest Implementation Cost

    Web-based online medical billing softwares are also highly desirable due to the reason, that they are economical and cost effective, as they do not require to make large upfront and hardware investment as compared to the conventional medical billing softwares.

  4. Shortest Training Time

    Online Medical Billing Systems, usually have a faster learning curve. With online training, tutorial and help material available over the internet, a Medical Biller or Medical Coder is easily able to send electronic medical claims within 2 days of training.

  5. Secure and Reliable

    Web Based Medical Billing Software are hosted and on state of the art Cloud networks, that can server thousands of users simultaneously across the contents with excellent speed and uninterrupted service with zero percent down time. State of the art Web Server Management Technology ensures the security reliability, availability and integrity of the online Medical Billing system with regular data backup, eliminating the chance of system crash and risks of data loss.

  6. Flexible Billing Packages

    Due to Software as a Service (SaaS) model that supports various plans and packages, Online Medical Billing Softwares fits everyone need in Medical Billing Industry from Medical Billing Companies to Medical Billing Home Business.

Online Medical Billing Software Reviews

Having said this all, let start Reviews of 5 Top Online Medical Billing Softwares available in the market at the moment:

CareCloud Comprehensive Medical billing Software
This is web based medical billing software that is sure to manage all your medical billing and eligibility with ease. Maximized profits and accuracy are some of the major benefits you stand to enjoy from CareCloud web based medical billing software . This software is able to eradicate the headaches related to trying to get paid with most sophisticated medical billing software. Carecloud is able to check on claims in real time and ensures they are 100% compliant before submission.



Medical Office Online
Medical office Online is an online medical billing software that is easy to set up and easy to learn online. This is software that makes the whole billing process paperless. One thing worth noting is that it is HIPAA compliant and web browser based application that also integrates as medical scheduling software. Medical office online is able to provide safe storage for patient records with ease of access while also acting as a perfect medical billing software.

Medical Office Online

AdvancedMD Medical Billing
Advanced MD solution acts as clinical and medical billing software with tools able to improve patient care while guaranteeing profitability in medical billing. This is certified interoperable cloud medical billing software that is perfect for creating a paperless medical office. It comes with advantages such as customizable templates, mobile access and web based Patient Portal. Return on investment with this medical billing software is always immediate with improved revenue capture from improved claims acceptance.



PractiseSuites Web-Based Medical Billing Software
With over 6000 subscriptions PractiseSuites cloud based medical billing software is what any medical billing company needs to solve all issues related to medical billing. It acts as complete medical billing software for billing purposes. It comes with powerful electronic claim and management capabilities that is perfect for automating all medical billing claims.

PractiseSuites Web-Based Medical Billing Software

NueMD Online Medical Billing Solution
This is a complete medical billing software solution that is easy to use .It is perfect for serving huge number of clients by reducing all the reimbursement cycles while increasing efficiency and accuracy in the billing process. NueMD is perfect for claim processing, reimbursement management, medical scheduling and patient statement collections. Being web based ensures it is secure and fast in the access of data stored and the processing of medical bills . It also ensures patients have access to all their electronic medical billing statements at any given time.

NueMD Online Medical Billing Solution

April 17, 2013

Medicaid Eligibility 2013

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Medicaid Eligibility 2013 Find Medicaid Eligibility 2013.

Medicaid is a government health insurance scheme that is usually provided to individuals who qualify for it.

The eligibility requirements vary from one state to another. Medicaid is designed for low income families to cater for medical bills and is federally created.

Some Medicaid eligibility groups are mandatory and every state is usually required to abide by them.

If you qualify for Medicaid your care provider will be receiving payment from the state you are in which will be covering for your medical services whenever you visit a medical facility You will not be required to pay for the services or receive the funds either in person.

Medicaid generally covers few specific illnesses such as tuberculosis breast and cervical cancer. Medicaid covers only specific group of people regardless of income.

Medicaid Eligibility 2013

To qualify for Medicaid you will need to be either a parent or guardian to a child of 18 years or below, must be pregnant , disabled or at least 65 years and above. Teenagers living on their own also qualify for Medicaid and also children in foster care up to the ages of 21.

Being a US citizen is a must to qualify for Medicaid or a lawfully admitted immigrant. If you are not a citizen your children depending on age and state might qualify for the program. Income eligibility depends on the federal poverty line. Pregnant women and children with an income of up to 185% of the poverty line are always eligible for full Medicaid cover. Families making up to 133% of the poverty line are usually covered under the same plan.

Medicaid Eligibility Changes

The eligibility for Medicaid varies from one state to another; elderly frail individuals have different requirements as compared to pregnant women. The elderly come with two types of eligibility requirements: functional and financial. Functionally elderly individuals must require the level of services provided by nursing homes. Financially Medicaid looks into the income of both the applicants and their spouses and the total resources or countable assets. Medicaid in this case also considers past asset transfers dating far back as 60 months prior to application.

To qualify for Medicaid in 2013 your income must be $2,130 a month and your resources exclusive of home and vehicle must be less than $2000. The level of income for eligibility varies from one state to another in others it is as low as $600 or as high as $3000. The resource limit in some states can reach as high as $15000. Countable resource also changes depending on state.

Blind and disabled individuals also qualify for Medicaid in many states. Coverage in this case is available to individuals who meet the social security administration standards for disability and are still working. If a disabled individual is enrolled under Medicare part he or she may also apply for Medicaid coverage.

Medicaid Eligibility and Community Spouse

Medicaid eligibility also comes down to something known as community spouse. In this case if one spouse requires care while the other spouse is as healthy as ever and lives independently, they are considered as community spouse. A complicated division of assets is usually done in this case while the ability of the community spouse to continue living independently is usually considered in determining Medicaid eligibility.

Medicaid Eligibility 2014

As from 2014 there will be a set of new rules governing eligibility of Medicaid and children insurance program. The method which is known as Modified Adjusted gross income MAGI will apply to most Medicaid eligibility groups’ children pregnant women and the elderly. MAGI methodology will be used in determining the income of individual or household eligible for Medicaid. It will only apply to certain group of people with their own unique income counting rules.

April 13, 2013

Medicare Part D Donut Hole, Coverage and Changes 2013

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Find Medicare Part D 2013 Changes, Medicare Donut Hole and Doughnut Hole Coverage Gapes along with Catastrophic Coverage Threshold. You can also check out:
Medicare Part D Donut Hole, Coverage and Changes 2013
Medicare comes in four parts A, B, C and D. Medicare Part D is most of the time referred to us doughnut hole due to the extraneous costs that it often comes with.

Medicare Part D was created in 2003 and only covers prescription drugs. This plan is available to all individuals who have either Medicare part A or B.

Medicare Part D Donut Hole

Medicare Part D coverage gap, commonly called Medicare Donut Hole, lies between the initial coverage limit and the catastrophic coverage threshold in the Medicare Part D prescription drug program by the United States Government.

Medicare Part D Donut Hole has been able to reduce the cost of prescription drugs for seniors by more than 13%. Medicare Part D Donut Hole is provided by private companies and not the federal government, you can buy part D as either a standalone or combined with A and B in Medicare advantage.

After a Medicare beneficiary exits the initial coverage of prescription-drug plan, the beneficiary is financially responsible for a higher cost of prescription drugs until he or she reaches the catastrophic-coverage threshold.

Medicare Part D Coverage

Medicare part D coverage works by one paying out of pocket monthly premiums per month, you will be required to pay 100% of your drugs until you reach $310 deductible amount. Ones you reach the deductible you will only pay 25% of the costs of your drugs while Medicare part D pays the rest. The Medicare will pay the rest till you and your plan reach $2800.

The doughnut hole sets in ones your drugs total more than the initial coverage limit and your part D will cease entirely. It is called the doughnut hole in the sense that regardless of one having an insurance and paying premiums one will not receive benefits for their medications. In this case a beneficiary is usually required to cater for all the costs of their prescription.

Medicare Part D Catastrophic Coverage

Catastrophic coverage will only kick in ones you spend another $3,610 on your drugs. Ones catastrophic coverage kicks in you will be required to cover only 5% of the costs of your drugs. There is a program called Medicare Extra Help that helps people pay their premiums and comes with reduced out of pocket costs for drugs.

Ones one reaches the donut level, financial challenges are most of the time known to set in, it are for this reason that the health reform law- the affordable care Act was enacted. This act helps in alleviating the burden of paying for the prescriptions ones you hit the donut level.

Medicare Part D 2013 Changes

Medicare Part D 2013 Changes for this year include, once you hit the donut hole you will be eligible for a onetime $250 rebate cheque. You will also receive a 50% discount on brand name drugs in the donut hole; you will also pay less and less for your generic part D drugs in the donut hole.

It is planned that as from 2020 the coverage gap will have been closed such that there will be no donut hole. In this case you will only pay 25% of the cost of your drugs until you reach the spending limit. You will also get continuous Medicare coverage throughout this time for your prescriptions as long as you are in the prescription drug plan

There is no need to keep track of your retail drug costs or retail drug spending, your Medicare part D plan provider will gather all the retail costs and keep a keen track of your record till you reach the donut hole Phase. You can also check out:

April 9, 2013

Medicare Part C Plans, Costs, Coverage 2013

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Find what does Medicare Part C Covers and Cost along with Medicare Part C Plans overview.

Medicare Part C Plans, Costs, Coverage 2013
Medicare part C is also called private insurance policy that essentially replaces Medicare part A and Medicare part B.

Once you enroll into Medicare part C you will not receive services of part A or B. It is an optional plan that helps to cover medical costs of which plan A or B cannot cover.

Medicare plan C is provided by private insurers and provides enhancements such as dental vision and hearing. In this case Medicare plan C is able to combine all the benefits of part A and part B all in one package.

Medicare plan C is an advantage plan as it is able to eliminate some medical payment deductibles and co payments. If you enroll into Medicare part C you will not need to buy a Medicare policy.

Medicare Part C Costs

Total pocket expenses with Medicare part C are usually lower as compared to a combination of part A and B plus a combination of the medigap insurance policy. Medicare part C comes in two basic types: managed care and fee for service.

Medicare Part C Plans

With Medicare managed plans you will only get full coverage of your medical costs if you visit a healthcare provider who is a member of the plans network. The most common and least expensive managed plans are health maintenance organizations. With fee for service Medicare service plans, you are always allowed to see any provider as long as they accept the plans restrictions on the particular medical service and accepts the amount the plan will be paying for the service offered.

The only unique thing with Medicare part C is that patients are usually required to work with facilities that are registered under the network offering this advantage plan. Traditional plans of part A and part B do not come with this requirement. Extra benefits including the coverage of prescription drugs vision and dental also fall under this Medicare plan.

Depending on the population needs Medicare part C might luck in some states. The private insurance companies that do offer this plans might differ in the premiums they charge depending on the locality of operation. There is a monthly premium payment that is usually required addition to the plan B premium payment requirement.

Health maintenance is the most common option under plan C Medicare as it is least expensive. The second plan is the Provider Sponsored Organization PSO; it is made up of facilities that provide medical care and insurance coverage. Everything is usually taken care of by PSO therefore no involvement of third part insurance entity.

Point of service POS is another Medicare advantage option that allows you to choose your own doctors and specialist. In this case Part C is known to pay less towards this service especially in instances where the doctors are not in the network. Preferred Provider Organization PPO is similar to POS, the only difference being the fact it is only available in rural areas. Point Of Service POS is usually available only in urban areas.

The type of plan that is suitable for any individual comes down to one’s healthcare needs. If you are an owner of a medigap insurance policy then you will not need Medicare advantage plan as they are almost similar.

Medicare Part C Coverage

Some Medicare advantage plan also covers non medical services like custodial care within a nursing facility or at home. Premiums are usually higher when covering medical care involving vision, dental and prescription costs. It is always good to do good research before deciding which plan to go with in this case. Plan availability will depend on the companies available in your area and their ability to stay for as long as you need them.

April 5, 2013

Medicare Part B Deductible and Coverage 2013

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Find Medicare Part B Deductible and Premium 2013 along with Medicare Part B Enrollment and details of what Medicare Part B covers.

Medicare Part A Deductibles and Copays Amount for 2013
Medicare part B is an optional medical scheme that covers all doctors service, outpatient hospital care durable medical care equipment and some other medical equipment and supplements.

Medicare part B is considered a supplemental insurance program as it covers all the treatments and procedures not covered under part A. It s premiums are usually deducted from the social security benefits.

Medicare part B also helps in covering some preventive services that help in maintaining a stable health by avoiding the spread of some illnesses in one’s body. You can also check out:

Medicare Part B Deductible 2013


As from 2013 one will be required to pay more for Medicare Part B of up to $147 which is an increase of $7 as compared to 2012. Ones you pay the $147 you will be eligible for a cover of up to of 80% of the approved amount. Most people pay standard premium amounts for Medicare Part B. The Internal revenue service considers Part B as a medical expense meaning you can deduct expenses greater than 7.5% of your adjusted gross income to cover for total medical care and dental expenses.

Medicare Part B Enrollment

If you already get social security benefits you will be automatically enrolled into Medicare part B. You also do have the option of declining part B or enroll at a future date but will be required to pay a late subscription fee. You can apply for social security benefits or Medicare if you are approaching 65 and have not yet enjoyed the benefits. It is usually good to apply prior to reaching 65 years say 3 months before so as to enjoy its full benefits.

medicare Part B Premium 2013

The monthly actuarial rates for 2013 will be $209.80 for aged enrolls while for disable enrollees it will stand at $235.50. The monthly premium rate will stand at $104.90 which is equal to 50% of the monthly actuarial rates. The actuarial rates for aged and disabled enrollees are used to determine the correct amount of general revenue financing per beneficiary month.

You can deduct a portion of your Medicare part B premiums from your income taxes of which you will first need to have a significant amount of the total medical expenses and must itemize your tax deductions. Social security deducts monthly premiums from your social security check list ones you receive the social security and apply for Part B Medicare coverage.

Enrolling to Medicare Part B is not mandatory but comes down to ones choice. If you don’t enroll ones you hit 65 you can also do the same under the general enrollment plan that takes place between January 1st of very year and march 31st. Your coverage in this case will begin from July 1st.

Medicare Part B Coverage

Medicare part A does not cover all the medical procedures that one might undergo. In this case Part B takes over whatever is left behind by part A. Some of the services covered by Medicare part B include non routine doctor visits outpatient surgery supplies and diagnostic tests. Part B also covers durable medical equipment such as wheelchairs, walkers, oxygen equipment and in-home hospital beds.

Medicare Part B will cover laboratory costs for services such as blood tests and screening tests. If a patient requires home based services then this plan also provides the cover. Taxpayers with status of married who file jointly for Medicare always end up paying high premiums if their gross income exceeds $170,000. Individuals who delay enrollment in Medicare part B past the initial enrollment period are always required to pay premiums that are up by up to 10% for each of the delayed 12 month period.

April 1, 2013

Medicare Part A Deductibles and Copays Amount for 2013

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Learn Medicare Part A Annual Deductibles Amounts, Copays and Benefit Period for 2013.
Medicare Part A Deductibles and Copays Amount for 2013

Medicare is a federally funded insurance scheme that covers people of the age of 65 and above depending on stipulated medical conditions. Medicare part A covers all eligible hospital and nursing facility costs.

People who have worked for more than ten years in the United States get at least some part of the Medicare for free, however the entire program is not free and comes with some costs associated with it. This costs form part of the deductibles. A deductible is the amount that a beneficiary must pay before the insurance steps in and starts to pay. You can also check out:

Medicare Part A Benefit Period

Deductibles are repeatable every benefit period and form part of the annual expense. Medicare Part A is a benefit period deductible that does not reset on the calendar year but only works on the basis of a benefit period. The benefit period begins from the time a patient is admitted in the hospital or a nursing facility and ends ones one receives a 60 day consecutive hospital care.

Medicare part A comes with benefit periods that begin from the first day you go into a hospital or a skilled nursing facility; if you stay in a hospital or a nursing facility for 60 consecutive days your benefit period ends. A new benefit period starts immediately you go into a hospital after the end of your previous benefit period.

Medicare Part A Deductibles Amount for 2013

Medicare did announce some changes in the deducible and coinsurance for Medicare Part A as from 2013. There will be an increase in the inpatient hospital deductible of $28 to $1,184. Medicare Part A not being an annual deductible means that a patient can be responsible for this payment for more than ones in a year.

The skilled nursing facility coinsurance will also experience an increase in 2013 of up to $148.00 per day for the days between 21 and 100. It is worth noting that the pay for 2012 was $144.50 per day for the first days between 0 and 20.

Medicare part A covers all the semi private, hospital room, meals and hospital services up to the 90th day during your benefit period. Ones you pay the deductibles, Medicare Part A will be able to cover all the charges for the first 60 days that you are in the hospital. You will only pay a coinsurance of $283 a day as from as from day 61 to day 90. It is worth noting that you pay all the charges as from day 90 unless you have not used all your 60 lifetime reserve days.

Medicare part A comes with 60 lifetime reserve days that always caters for all the hospital charges beyond the normal 90 day limit. You are eligible to use your reserve days whenever you are in the hospital for more than 90 days but ones you hit the 60th day of the reserve days you will be required to pay a coinsurance of $566 a day

If you happen to be admitted in a hospital facility for at least 3 days and then go into a nursing facility, Medicare will only be able to pay your nursing facility costs for the first 20 days. As from day 21 to 100 you will be required to pay a coinsurance of $141.50 day. One can qualify for Medicare Part A if he or she is struggling to pay the deductibles due to low income.

March 23, 2013

CPT Codes for Pap Smear Collection, Screening

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CPT codes for Pap smear are (88141-88175) and HCPCS Codes use to report for both screening and Diagnostic pap smear. List of HCPCS codes and CPT codes for Pap smear coding and billing Commercial insurance and Medicare.

CPT Codes for Pap Smear Collection, Screening

CPT Codes for Pap Smear Screening and Diagnostic Devices

Pap smear procedure codes with detail description are:
  1. CPT code 88141
    Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician

  2. CPT code 88142
    Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision

  3. CPT code 88143
    Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and re screening under physician supervision

  4. CPT code 88147
    Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision

  5. CPT code 88148
    Cytopathology smears, cervical or vaginal; screening by automated system with manual re screening under physician supervision

  6. CPT code 88150
    Cytopathology, slides, cervical or vaginal; manual screening under physician supervision

  7. CPT code 88152
    Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted re screening under physician supervision

  8. CPT code 88153
    Cytopathology, slides, cervical or vaginal; with manual screening and re screening under physician supervision

  9. CPT code 88154
    Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted re screening using cell selection and review under physician supervision

  10. CPT code 88155
    Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation

  11. CPT code 88164
    Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision

  12. CPT code 88165
    Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and re screening under physician supervision

  13. CPT code 88166
    Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted re screening under physician supervision

  14. CPT code 88167
    Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted re screening using cell selection and review under physician supervision

  15. CPT code 88174
    Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision
  16. CPT code 88175
    Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual re screening or review, under physician supervision

HCPCS Codes for Pap Smear Tests

Following HCPCS G codes and P codes use to report for Papanicolaou test:
  1. CPT code G0123
    Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid,automated thin layer preparation, screening
    by cytotechnologist under physician supervision.

  2. CPT code G0143
    Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid,automated thin layer preparation, with manual screening and re screening by cytotechnologist under physician supervision

  3. CPT code G0144
    Screening cytopathology, cervical or vaginal (any reporting system),
    collected in preservative fluid, automated thin layer preparation, with screening by automated system under physician supervision

  4. CPT code G0145
    Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual re screening under physician supervision

  5. CPT code G0147
    Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision

  6. CPT code G0148
    Screening cytopathology smears, cervical or vaginal, performed by automated system with manual re screening

  7. CPT code P3000
    Screening Papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision

  8. CPT code G0124
    Screening cytopathology, cervical or vaginal (any reporting system),collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician

  9. CPT code G0141
    Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual re screening, requiring interpretation by physician

  10. CPT code P3001
    Screening Papanicolaou smear, cervical or vaginal, up to three smears,requiring interpretation by physician

March 20, 2013

Medicare Advantage Plans covers Annual Wellness Visit in Aetna (MA)

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Annual wellness visit is now covered in Aetna (MA) Medicare advantage Plan, effective from the 01/01/2013. This change was made as a result of a change in coverage made by the Centers for Medicare and Medicaid Services (CMS).

Medicare Advantage Plans now covers Annual Wellness Visit in Aetna (MA)

Aetna Medicare Advantage Plans of 2013 start providing coverage for billing Annual Wellness Visit of patients. Aetna MA insurance plan is now eligible to cover an annual wellness visit. The Annual Physical Exam will not be covered by Aetna Medicare Advantage Plan.

CPT Codes for billing and coding annual wellness visit:

CPT Code G0438 Annual Wellness Visit includes a personalized prevention plan of service, initial visit.

CPT Code G0439 Annual Wellness Visit includes a personalized prevention plan of service (pps), subsequent visit.

Do not bill MA Plans the Preventive CPT codes for the Annual Physical Exam. Preventive CPT Codes are 99381-99397, 99401-99404, 99201-99205 and 99211-99215 with primary diagnosis of preventive.

The preventive diagnosis codes that are not covered are: V03.0-V03.9, V04.0-V04.89, V05.0-V05.9, V06.0-V06.9, V20.0-V20.2, V70.0, V70.3, V70.5