'Inkonzo yeeNkqubo ezihlukileyo' kuquka ne-4 iinguqulelo

I-Modifier 59 ngumguquleli ochongiweyo ukuchonga iinkonzo okanye iinkqubo ezenziwa ngosuku olufanayo njengenkonzo enxulumene nenkqubo ngenxa yeemeko ezizodwa xa ezi nkonzo okanye iinkqubo aziqhelwanga ngokuqhelekileyo kunye. Ngokuqhelekileyo, i-modifier 59 yongezwa kwiikhowudi ze-HCPCS / CPT xa ifom yebango yokubhengeza ibonisa iinkqubo ezimbini okanye ezininzi ezahlukileyo zenziwa kwiindawo zomzimba ezahlukeneyo, izitho, okanye indawo eyingozi okanye ukuhlangana okufanayo ngosuku olufanayo lwenkonzo ngudokotela ofanayo.

I-CMS isebenzisa ezine iinguqulelo ezithatha indawo yokuguqula 59 kwiimeko ezithile. Ngokutsho kweCMS, i-modifier 59 yindlela yokuguqulwa kakhulu kunazo zonke kunye ne-modifier engalunganga. I-Modifier 59 ibe yimbangela yokuphicothwa kwababoneleli, ukuphononongwa, izibheno, kunye nobuqhetseba kunye nokusetyenziswa kakubi ngenxa yamathuba angasetyenziswayo.

Nangona i-CMS iqhubeka ivuma kwaye iyakwamukela ukusetyenziswa kwe-modifier 59, yongezelela i-subsets enye eyongezelelweyo ye-modifier 59 ngoJanuwari 1, 2015. Ezi ngqungquthela zibonelela ngesizathu esicacileyo okanye esichazayo.

• XE Ukuhlangana okuhlukile
• XS Ulwakhiwo oluhlukileyo
• XP
• I-XU Isevisi engaqhelekanga yokuThatyathwa

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Umhleli weXE: Ukudibanisa okuhlukile

Umhleli weXE: Ukudibanisa okuhlukile

Inkcazo: Inkonzo ecacileyo ngenxa yokuba yenzeke ngexesha lokuhlangana.

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Umhleli we-XS: Ulwakhiwo oluhlukileyo

Umhleli we-XS: Ulwakhiwo oluhlukileyo

Inkcazo: inkonzo ecacileyo ngenxa yokuba yayenziwe kwilungu / isakhiwo esithile.

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Umhleli we-XP: uMsebenzi ohlukeneyo

Umhleli we-XP: uMsebenzi ohlukeneyo

Inkcazo: inkonzo ecacileyo ngenxa yokuba yenziwa ngumbhali ohlukeneyo.

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Umhleli we-XU: Isevisi engaqhelekanga yokuThatyathwa

Umhleli we-XU: Isevisi engaqhelekanga yokuThatyathwa

Inkcazo: isevisi ye-oo eyahlukileyo ngenxa yokuba ayifaki kwizinto eziqhelekileyo zenkonzo enkulu.

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Iinguqulelo 59: IiNkonzo zeNkqubo eziPhakathi

Iinguqulelo 59: IiNkonzo zeNkqubo eziPhakathi

Inkcazo: Isamkeleka ngaphandle kweemeko apho kukho umququzeleli othe ngqo

Ukongeza, akuyi kulungele ukusebenzisa i-modifier 59 kunye nabanye abaguquleli. Ukusetyenziswa okufanelekileyo kwe-modifier 59 kufuneka kuqulunqwe ngokubhekiselele kwinkqubo ye-reference ye-NCCI yokulungisa inkqubo ngokuvakashela i-www.cms.gov/Medicare.

Kaninzi

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I-NCCI Inkqubo-yoNkqubo-nkqubo

I-NCCI inqubo-yoku-nkqubo yokulungisa ikhusela ukunika ingxelo kunye nokuhlawulwa kweenkonzo ezingenakuhlawulwa kwiibango ndawonye. Ukulungiswa kwe-NCCI kufumaneka kwiibhile ezine ezibonelelwe kwiwebsite yeCMS.

Ezi tafile zibhekiselele kwizibhedlele kunye namagqirha ukuba achaze iiseti zeekhowudi ezingenako ukungeniswa kwibango elifanayo okanye zidibeneyo. Ukuba ibango linamakhowudi amabini, kukho iindlela ezimbini ezinokuthi zenzeke:

1. Ngokusekelwe ekubeni ngaba ikhowudi ibhalwe kwikholam 1 okanye ikholamu 2 yetafile, ikhowudi yekholamu 2 iya kukhanyela. Umzekelo: Umniki-mboleko akafanelekanga ingxelo yezilwanyana ezixilongwa ngokungaxilwanga kunye ne-diagnostic mammogram. I-unilateral diagnostic mammogram ayiyi kufaneleka ukuhlawula.
2. Ukuba itheyibhile ibonisa ukuba kukho umququzeleli ofanelekileyo weklinikhi kunye ne-modifier isetyenziswe, zombini iikholomu ziya kulungeleka. Umzekelo: Sebenzisa i-Modifier 59 kunye nenkqubo yesibini, eyongezelelweyo okanye encinane njengoko ibhalwe kwikholam 1 okanye ikholamu 2 ngokufanelekileyo.