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99177
Quick jump to procedure code: Printer Friendly Version
99184

Procedure Category: Medicine
Procedure Subcategory: Other Services and Procedures

99183: HYPERBARIC OXYGEN THERAPY

CPT® 99183: Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session



--

CPT copyright 2018 American Medical Association. All rights reserved.


Medicare Reimbursement Information         Hide this section.

Unadjusted-National Fee Schedule Amount
ALABAMA-Entire State
ALASKA-Entire State
ARIZONA-Entire State
ARKANSAS-Entire State
CALIFORNIA NORTH-Napa
CALIFORNIA NORTH-San Francisco
CALIFORNIA NORTH-San Mateo
CALIFORNIA NORTH-Oakland/Berkeley
CALIFORNIA NORTH-Santa Clara
CALIFORNIA NORTH-Yuba City
CALIFORNIA NORTH-San Francisco/Oakland/Hayward (Marin County)
CALIFORNIA NORTH-Vallejo/Fairfield
CALIFORNIA NORTH-Bakersfield
CALIFORNIA NORTH-Chico
CALIFORNIA NORTH-Fresno
CALIFORNIA NORTH-Hanford/Corcoran
CALIFORNIA NORTH-Madera
CALIFORNIA NORTH-Merced
CALIFORNIA NORTH-Modesto
CALIFORNIA NORTH-Redding
CALIFORNIA NORTH-Riverside/San Bernardino/Ontario
CALIFORNIA NORTH-Sacramento/Roseville/Arden/Arcade
CALIFORNIA NORTH-Salinas
CALIFORNIA NORTH-San Jose/Sunnyvale/Santa Clara (San Benito County)
CALIFORNIA NORTH-Santa Cruz/Watsonville
CALIFORNIA NORTH-Santa Rosa
CALIFORNIA NORTH-Stockton/Lodi
CALIFORNIA NORTH-Visalia/Porterville
CALIFORNIA SOUTH-Ventura
CALIFORNIA SOUTH-Los Angeles
CALIFORNIA SOUTH-Anaheim/Santa Ana
CALIFORNIA SOUTH-El Centro
CALIFORNIA SOUTH-San Diego/Carlsbad
CALIFORNIA SOUTH-San Luis Obispo/Paso Robles/Arroyo Grande
CALIFORNIA SOUTH-Santa Maria/Santa Barbara
COLORADO-Entire State
CONNECTICUT-Entire State
DELAWARE-Entire State
DIST of COL-DC + MD/VA Suburbs
FLORIDA-Ft Lauderdale
FLORIDA-Miami
FLORIDA-Rest of Florida
GEORGIA-Atlanta
GEORGIA-Rest of Georgia
HAWAII/GUAM-Entire State/Terr.
IDAHO-Entire State
ILLINOIS-East St. Louis
ILLINOIS-Suburban Chicago
ILLINOIS-Chicago
ILLINOIS-Rest of Illinois
INDIANA-Entire State
IOWA-Entire State
KANSAS-Entire State
KENTUCKY-Entire State
LOUISIANA-New Orleans
LOUISIANA-Rest of Louisiana
MAINE-Southern Maine
MAINE-Rest of Maine
MARYLAND-Baltimore and suburbs
MARYLAND-Rest of Maryland
MASSACHUSETTS-Boston
MASSACHUSETTS-Rest of Massachusetts
MICHIGAN-Detroit
MICHIGAN-Rest of Michigan
MINNESOTA-Entire State
MISSISSIPPI-Entire State
MISSOURI-Kansas City
MISSOURI-St. Louis
MISSOURI-Rest of Missouri
MONTANA-Entire State
NEBRASKA-Entire State
NEVADA-Entire State
NEW HAMPSHIRE-Entire State
NEW JERSEY-Northern NJ
NEW JERSEY-Rest of New Jersey
NEW MEXICO-Entire State
NEW YORK-Manhattan
NEW YORK-NYC Suburbs/LI
NEW YORK-Poughkpsie/No NYC Sub
NEW YORK-Rest of New York
NEW YORK-Queens
NORTH CAROLINA-Entire State
NORTH DAKOTA-Entire State
OHIO-Entire State
OKLAHOMA-Entire State
OREGON-Portland
OREGON-Rest of Oregon
PENNSYLVANIA-Philadelphia
PENNSYLVANIA-Rest of Pennsylvania
PUERTO RICO-Entire Territory
RHODE ISLAND-Entire State
SOUTH CAROLINA-Entire State
SOUTH DAKOTA-Entire State
TENNESSEE-Entire State
TEXAS-Brazoria
TEXAS-Dallas
TEXAS-Galveston
TEXAS-Houston
TEXAS-Beaumont
TEXAS-Fort Worth
TEXAS-Austin
TEXAS-Rest of Texas
UTAH-Entire State
VERMONT-Entire State
VIRGIN ISLANDS-Entire State
VIRGINIA-Entire State
WASHINGTON-Seattle (King County)
WASHINGTON-Rest of Washington
WEST VIRGINIA-Entire State
WISCONSIN-Entire State
WYOMING-Entire State

Global Fee $112.44

2019A OPPS Status Indicator: B

Effective April 1, 2013, and while sequestration is in effect, all CMS payments for services will be reduced by 2%. The fees above do not reflect this reduction. Click here for more information.

Commonly Associated Diagnosis Codes*            Hide this section.
Percentage
ICD-10 Code
Description
Related DRG(s)
26.4%
E11.621
Type 2 diabetes mellitus with foot ulcer
008
010
637-639
10.6%
L59.9
Disorder of the skin and subcutaneous tissue related to radiation, unspecified
606-607
4.9%
N30.41
Irradiation cystitis with hematuria
698-700
4.8%
L59.8
Other specified disorders of the skin and subcutaneous tissue related to radiation
606-607
2.5%
M86.68
Other chronic osteomyelitis, other site
456-458
539-541
2.5%
E11.622
Type 2 diabetes mellitus with other skin ulcer
008
010
637-639
2.4%
T86.821
Skin graft (allograft) (autograft) failure
919-921
2.4%
M86.672
Other chronic osteomyelitis, left ankle and foot
539-541
2.3%
M27.8
Other specified diseases of jaws
011-013
157-159
1.8%
M86.671
Other chronic osteomyelitis, right ankle and foot
539-541

* Commonly Associated ICD-10 codes derived from CMS Q3 2016 Limited Data Set (LDS) claims data.
This data represents an analysis of 11,119,991 claims processed for 1,414,138 beneficiaries in the third quarter of 2016.

Medicare Coverage Policy Information         Hide this section.
No contractor selected.

National Coverage Determination requiring specific diagnosis codes- NCD for 99183


CCI and MUE Edits*         Hide this section.

Multiple Code CCI/MUE Edit Report-New

Column 1 CCI Edits for 99183
Denied Codes (1)
Effective
Modifier
Accepted (2)
0405T OVRSGHT XTRCORP LIV ASST PAT
01/01/2016 Yes
36591 DRAW BLOOD OFF VENOUS DEVICE
10/01/2015 No
36592 COLLECT BLOOD FROM PICC
10/01/2015 No
96160 PT-FOCUSED HLTH RISK ASSMT
01/01/2017 Yes
96161 CAREGIVER HEALTH RISK ASSMT
01/01/2017 Yes
99201 OFFICE/OUTPATIENT VISIT NEW
10/01/2015 Yes
99202 OFFICE/OUTPATIENT VISIT NEW
10/01/2015 Yes
99203 OFFICE/OUTPATIENT VISIT NEW
10/01/2015 Yes
99204 OFFICE/OUTPATIENT VISIT NEW
10/01/2015 Yes
99205 OFFICE/OUTPATIENT VISIT NEW
10/01/2015 Yes
99211 OFFICE/OUTPATIENT VISIT EST
10/01/2015 Yes
99212 OFFICE/OUTPATIENT VISIT EST
10/01/2015 Yes
99213 OFFICE/OUTPATIENT VISIT EST
10/01/2015 Yes
99214 OFFICE/OUTPATIENT VISIT EST
10/01/2015 Yes
99215 OFFICE/OUTPATIENT VISIT EST
10/01/2015 Yes
99217 OBSERVATION CARE DISCHARGE
10/01/2015 Yes
99218 INITIAL OBSERVATION CARE
10/01/2015 Yes
99219 INITIAL OBSERVATION CARE
10/01/2015 Yes
99220 INITIAL OBSERVATION CARE
10/01/2015 Yes
99221 INITIAL HOSPITAL CARE
10/01/2015 Yes
99222 INITIAL HOSPITAL CARE
10/01/2015 Yes
99223 INITIAL HOSPITAL CARE
10/01/2015 Yes
99224 SUBSEQUENT OBSERVATION CARE
10/01/2015 Yes
99225 SUBSEQUENT OBSERVATION CARE
10/01/2015 Yes
99226 SUBSEQUENT OBSERVATION CARE
10/01/2015 Yes
99231 SUBSEQUENT HOSPITAL CARE
10/01/2015 Yes
99232 SUBSEQUENT HOSPITAL CARE
10/01/2015 Yes
99233 SUBSEQUENT HOSPITAL CARE
10/01/2015 Yes
99234 OBSERV/HOSP SAME DATE
10/01/2015 Yes
99235 OBSERV/HOSP SAME DATE
10/01/2015 Yes
99236 OBSERV/HOSP SAME DATE
10/01/2015 Yes
99238 HOSPITAL DISCHARGE DAY
10/01/2015 Yes
99239 HOSPITAL DISCHARGE DAY
10/01/2015 Yes
99241 OFFICE CONSULTATION
10/01/2015 Yes
99242 OFFICE CONSULTATION
10/01/2015 Yes
99243 OFFICE CONSULTATION
10/01/2015 Yes
99244 OFFICE CONSULTATION
10/01/2015 Yes
99245 OFFICE CONSULTATION
10/01/2015 Yes
99251 INPATIENT CONSULTATION
10/01/2015 Yes
99252 INPATIENT CONSULTATION
10/01/2015 Yes
99253 INPATIENT CONSULTATION
10/01/2015 Yes
99254 INPATIENT CONSULTATION
10/01/2015 Yes
99255 INPATIENT CONSULTATION
10/01/2015 Yes
99281 EMERGENCY DEPT VISIT
10/01/2015 Yes
99282 EMERGENCY DEPT VISIT
10/01/2015 Yes
99283 EMERGENCY DEPT VISIT
10/01/2015 Yes
99284 EMERGENCY DEPT VISIT
10/01/2015 Yes
99285 EMERGENCY DEPT VISIT
10/01/2015 Yes
99288 DIRECT ADVANCED LIFE SUPPORT
10/01/2015 Yes
99291 CRITICAL CARE FIRST HOUR
10/01/2015 Yes
99292 CRITICAL CARE ADDL 30 MIN
10/01/2015 Yes
99304 NURSING FACILITY CARE INIT
10/01/2015 Yes
99305 NURSING FACILITY CARE INIT
10/01/2015 Yes
99306 NURSING FACILITY CARE INIT
10/01/2015 Yes
99307 NURSING FAC CARE SUBSEQ
10/01/2015 Yes
99308 NURSING FAC CARE SUBSEQ
10/01/2015 Yes
99309 NURSING FAC CARE SUBSEQ
10/01/2015 Yes
99310 NURSING FAC CARE SUBSEQ
10/01/2015 Yes
99315 NURSING FAC DISCHARGE DAY
10/01/2015 Yes
99316 NURSING FAC DISCHARGE DAY
10/01/2015 Yes
99318 ANNUAL NURSING FAC ASSESSMNT
10/01/2015 Yes
99324 DOMICIL/R-HOME VISIT NEW PAT
10/01/2015 Yes
99325 DOMICIL/R-HOME VISIT NEW PAT
10/01/2015 Yes
99326 DOMICIL/R-HOME VISIT NEW PAT
10/01/2015 Yes
99327 DOMICIL/R-HOME VISIT NEW PAT
10/01/2015 Yes
99328 DOMICIL/R-HOME VISIT NEW PAT
10/01/2015 Yes
99334 DOMICIL/R-HOME VISIT EST PAT
10/01/2015 Yes
99335 DOMICIL/R-HOME VISIT EST PAT
10/01/2015 Yes
99336 DOMICIL/R-HOME VISIT EST PAT
10/01/2015 Yes
99337 DOMICIL/R-HOME VISIT EST PAT
10/01/2015 Yes
99339 DOMICIL/R-HOME CARE SUPERVIS
10/01/2015 Yes
99340 DOMICIL/R-HOME CARE SUPERVIS
10/01/2015 Yes
99341 HOME VISIT NEW PATIENT
10/01/2015 Yes
99342 HOME VISIT NEW PATIENT
10/01/2015 Yes
99343 HOME VISIT NEW PATIENT
10/01/2015 Yes
99344 HOME VISIT NEW PATIENT
10/01/2015 Yes
99345 HOME VISIT NEW PATIENT
10/01/2015 Yes
99347 HOME VISIT EST PATIENT
10/01/2015 Yes
99348 HOME VISIT EST PATIENT
10/01/2015 Yes
99349 HOME VISIT EST PATIENT
10/01/2015 Yes
99350 HOME VISIT EST PATIENT
10/01/2015 Yes
99354 PROLONG E&M/PSYCTX SERV O/P
10/01/2015 Yes
99355 PROLONG E&M/PSYCTX SERV O/P
10/01/2015 Yes
99356 PROLONGED SERVICE INPATIENT
10/01/2015 Yes
99357 PROLONGED SERVICE INPATIENT
10/01/2015 Yes
99358 PROLONG SERVICE W/O CONTACT
10/01/2015 Yes
 
Denied Codes (1)
Effective
Modifier
Accepted (2)
99359 PROLONG SERV W/O CONTACT ADD
10/01/2015 Yes
99360 PHYSICIAN STANDBY SERVICES
10/01/2015 Yes
99366 TEAM CONF W/PAT BY HC PROF
10/01/2015 Yes
99367 TEAM CONF W/O PAT BY PHYS
10/01/2015 Yes
99368 TEAM CONF W/O PAT BY HC PRO
10/01/2015 Yes
99374 HOME HEALTH CARE SUPERVISION
10/01/2015 Yes
99375 HOME HEALTH CARE SUPERVISION
10/01/2015 Yes
99377 HOSPICE CARE SUPERVISION
10/01/2015 Yes
99378 HOSPICE CARE SUPERVISION
10/01/2015 Yes
99379 NURSING FAC CARE SUPERVISION
10/01/2015 Yes
99380 NURSING FAC CARE SUPERVISION
10/01/2015 Yes
99381 INIT PM E/M NEW PAT INFANT
10/01/2015 Yes
99382 INIT PM E/M NEW PAT 1-4 YRS
10/01/2015 Yes
99383 PREV VISIT NEW AGE 5-11
10/01/2015 Yes
99384 PREV VISIT NEW AGE 12-17
10/01/2015 Yes
99385 PREV VISIT NEW AGE 18-39
10/01/2015 Yes
99386 PREV VISIT NEW AGE 40-64
10/01/2015 Yes
99387 INIT PM E/M NEW PAT 65+ YRS
10/01/2015 Yes
99391 PER PM REEVAL EST PAT INFANT
10/01/2015 Yes
99392 PREV VISIT EST AGE 1-4
10/01/2015 Yes
99393 PREV VISIT EST AGE 5-11
10/01/2015 Yes
99394 PREV VISIT EST AGE 12-17
10/01/2015 Yes
99395 PREV VISIT EST AGE 18-39
10/01/2015 Yes
99396 PREV VISIT EST AGE 40-64
10/01/2015 Yes
99397 PER PM REEVAL EST PAT 65+ YR
10/01/2015 Yes
99401 PREVENTIVE COUNSELING INDIV
10/01/2015 Yes
99402 PREVENTIVE COUNSELING INDIV
10/01/2015 Yes
99403 PREVENTIVE COUNSELING INDIV
10/01/2015 Yes
99404 PREVENTIVE COUNSELING INDIV
10/01/2015 Yes
99406 BEHAV CHNG SMOKING 3-10 MIN
10/01/2015 Yes
99407 BEHAV CHNG SMOKING > 10 MIN
10/01/2015 Yes
99408 AUDIT/DAST 15-30 MIN
10/01/2015 Yes
99409 AUDIT/DAST OVER 30 MIN
10/01/2015 Yes
99411 PREVENTIVE COUNSELING GROUP
10/01/2015 Yes
99412 PREVENTIVE COUNSELING GROUP
10/01/2015 Yes
99415 PROLONG CLINCL STAFF SVC
01/01/2016 Yes
99416 PROLONG CLINCL STAFF SVC ADD
01/01/2016 Yes
99441 PHONE E/M PHYS/QHP 5-10 MIN
10/01/2015 Yes
99442 PHONE E/M PHYS/QHP 11-20 MIN
10/01/2015 Yes
99443 PHONE E/M PHYS/QHP 21-30 MIN
10/01/2015 Yes
99444 ONLINE E/M BY PHYS/QHP
10/01/2015 Yes
99446 NTRPROF PH1/NTRNET/EHR 5-10
10/01/2015 Yes
99447 NTRPROF PH1/NTRNET/EHR 11-20
10/01/2015 Yes
99448 NTRPROF PH1/NTRNET/EHR 21-30
10/01/2015 Yes
99449 NTRPROF PH1/NTRNET/EHR 31/>
10/01/2015 Yes
99450 BASIC LIFE DISABILITY EXAM
10/01/2015 Yes
99451 NTRPROF PH1/NTRNET/EHR 5/>
01/01/2019 Yes
99452 NTRPROF PH1/NTRNET/EHR RFRL
01/01/2019 Yes
99455 WORK RELATED DISABILITY EXAM
10/01/2015 Yes
99456 DISABILITY EXAMINATION
10/01/2015 Yes
99460 INIT NB EM PER DAY HOSP
10/01/2015 Yes
99461 INIT NB EM PER DAY NON-FAC
10/01/2015 Yes
99462 SBSQ NB EM PER DAY HOSP
10/01/2015 Yes
99463 SAME DAY NB DISCHARGE
10/01/2015 Yes
99464 ATTENDANCE AT DELIVERY
10/01/2015 Yes
99465 NB RESUSCITATION
10/01/2015 Yes
99466 PED CRIT CARE TRANSPORT
10/01/2015 Yes
99467 PED CRIT CARE TRANSPORT ADDL
10/01/2015 Yes
99468 NEONATE CRIT CARE INITIAL
10/01/2015 Yes
99469 NEONATE CRIT CARE SUBSQ
10/01/2015 Yes
99471 PED CRITICAL CARE INITIAL
10/01/2015 Yes
99472 PED CRITICAL CARE SUBSQ
10/01/2015 Yes
99475 PED CRIT CARE AGE 2-5 INIT
10/01/2015 Yes
99476 PED CRIT CARE AGE 2-5 SUBSQ
10/01/2015 Yes
99477 INIT DAY HOSP NEONATE CARE
10/01/2015 Yes
99478 IC LBW INF < 1500 GM SUBSQ
10/01/2015 Yes
99479 IC LBW INF 1500-2500 G SUBSQ
10/01/2015 Yes
99480 IC INF PBW 2501-5000 G SUBSQ
10/01/2015 Yes
99483 ASSMT & CARE PLN PT COG IMP
01/01/2018 Yes
99484 CARE MGMT SVC BHVL HLTH COND
01/01/2018 Yes
99485 SUPRV INTERFACILTY TRANSPORT
10/01/2015 Yes
99486 SUPRV INTERFAC TRNSPORT ADDL
10/01/2015 Yes
99487 CMPLX CHRON CARE W/O PT VSIT
10/01/2015 Yes
99489 CMPLX CHRON CARE ADDL 30 MIN
10/01/2015 Yes
99490 CHRON CARE MGMT SRVC 20 MIN
10/01/2015 Yes
99491 CHRNC CARE MGMT SVC 30 MIN
01/01/2019 Yes
99492 1ST PSYC COLLAB CARE MGMT
01/01/2018 Yes
99493 SBSQ PSYC COLLAB CARE MGMT
01/01/2018 Yes
99494 1ST/SBSQ PSYC COLLAB CARE
01/01/2018 Yes
99495 TRANS CARE MGMT 14 DAY DISCH
10/01/2015 Yes
99496 TRANS CARE MGMT 7 DAY DISCH
10/01/2015 Yes
99497 ADVNCD CARE PLAN 30 MIN
01/01/2016 Yes
99498 ADVNCD CARE PLAN ADDL 30 MIN
01/01/2016 Yes
G0506 Comp asses care plan ccm svc
07/01/2017 Yes
G0511 Ccm/bhi by rhc/fqhc 20min mo
01/01/2019 Yes
G0512 Cocm by rhc/fqhc 60 min mo
01/01/2019 Yes
(1) These codes will be denied when submitted for payment on the same date of service as 99183.

(2) "Yes" indicates that the use of a modifier with the denied code will overcome the edit and allow payment.
"No" indicates that the second code will always be denied.



Column 2 CCI Edits for 99183

Denied Codes (1)
Effective
Modifier
Accepted (2)
77427 RADIATION TX MANAGEMENT X5
07/01/2001 No
77431 RADIATION THERAPY MANAGEMENT
07/01/2001 No
77432 STEREOTACTIC RADIATION TRMT
07/01/2001 No
 
Denied Codes (1)
Effective
Modifier
Accepted (2)
77435 SBRT MANAGEMENT
01/01/2007 No
77469 IO RADIATION TX MANAGEMENT
01/01/2012 No
77470 SPECIAL RADIATION TREATMENT
07/01/2001 No
(1) These codes will be denied when submitted for payment on the same date of service as 99183.

(2) "Yes" indicates that the use of a modifier with the denied code will overcome the edit and allow payment.
"No" indicates that the second code will always be denied.


Medically Unlikely Edits for 99183


Practitioner
Hospital Outpatient
DME Supplier
Allowed Frequency per Day: 1 1 Not Listed
Adjudication Indicator: 3 Date of Service Edit: Clinical 3 Date of Service Edit: Clinical Not Listed
Rationale: Clinical: Data Clinical: Data Not Listed

* CCI Source Data: Practitioner P2P Coding Edits. For more information on these edits or to view the Hospital Outpatient Edits, please visit https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

MUE Source Data: For more information on these edits, please visit href='https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE.html

The responsibility for the content of any "National Correct Coding Policy" included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse, or interpretation of information contained in this product.



   99183 Top 5 Ordering Providers National* - Extended NPI Market Analysis Search
RAFAEL RAFOLS -EDINBURG,TX 1,829
HENRY PRINCE -WOODBURY,NY 1,676
ERIE AGUSTIN -WOODSIDE,NY 1,342
JOHN THOMPSON -ARLINGTON,TX 1,309
RICHARD KING -MARIETTA,GA 1,223

*Based on 2016 Medicare Fee-For Service Provider Utilization & Payment Data, Physician and Other Supplier, Public Use File



   Medicare Part B Utilization Data for 99183*         Hide this section.



Annual Performed / Denied


Total National Services (all modifiers) Submitted 2017: 524,065
Total Services Denied 2017: 79,175 (15.1%)
National Charges Submitted 2017: $201,555,211.45
National Charges Allowed 2017: $ 48,727,348.73
National Average (No Modifier) Fee Submitted 2017: $385.22
National Average (No Modifier) Fee Allowed 2017: $109.52
National Average (26) Fee Submitted 2017: $183.50
National Average (26) Fee Allowed 2017: $ 0.00


Top 5 Performing Specialties 2017 Total Services Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
General surgery 105,833 20.2% $404.75 14,537 13.7%
Family practice 81,823 15.6% $369.39 11,076 13.5%
Internal medicine 73,528 14.0% $356.20 13,426 18.3%
Emergency medicine
(eff 5/92)
62,798 12.0% $391.15 9,464 15.1%
Nurse practitioner 27,599 5.3% $387.31 3,398 12.3%

Top 5 Places of Service 2017 Total Services Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
On Campus-Outpatient Hospital 416,082 79.4% $371.95 59,927 14.4%
Off Campus- Outpatient Hospital 51,640 9.9% $415.40 6,000 11.6%
Office 31,073 5.9% $442.26 6,529 21.0%
Inpatient hospital 22,586 4.3% $466.20 5,464 24.2%
Independent Clinic 2,020 0.4% $399.60 764 37.8%

Top 5 Modifiers Submitted 2017 Total Services Percent
of Total
Average
Amount
Submitted
Denials Percent
Denied
No Modifier 506,905 96.7% $385.22 74,194 14.6%
59 - Distinct Procedural Service 2,761 0.5% $306.14 699 25.3%
AQ 2,643 0.5% $340.39 445 16.8%
Q6 - Physician Services 2,524 0.5% $354.10 310 12.3%
GC 2,138 0.4% $430.98 254 11.9%

Click here for more information on Custom CodeMap Medicare Utililation Reports.


*Utilization data is derived from analysis of the Physician Supplier Procedure Summary Master File (PSPSMF) which includes data from all Medicare Part B carriers. This data represents procedure-specific billing data for all physician/supplier services rendered to all Medicare beneficiaries during the calendar year named and processed by the Carriers through the six months of the following year.

Part B charge and utilization data for institutional services (hospital outpatient departments, home health agencies, comprehensive outpatient rehabilitation facilities, end-stage renal disease facilities, and rural health clinics) are processed by Medicare Part A fiscal intermediaries and are not included in this data. Data for services rendered to beneficiaries enrolled in risk-based Health Maintenance Organizations (HMOs) are also not included.

All information on this web site is compiled directly from information obtained from the Center for Medicare and Medicaid Services (CMS) and from its Contractors.

CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on this web site. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

No part of this web page or data displayed may be redistibuted or used without the express written consent of Wheaton Partners, LLC.
01/23/2019 08:36:15 54.172.221.7

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