S No PROCEDURE NAME OPD PROCEDURES 1 Dressings of Wounds 2 Aspiration Plural Effusion
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Procedure Code List Effective Jan. 1, 2020 for Preauthorization for Blue Cross and Blue Shield of New Mexico Medicare Advantage Members Only
Procedure Code List Effective Jan. 1, 2020 for Preauthorization for Blue Cross and Blue Shield of New Mexico Medicare Advantage Members only Beginning Jan. 1, 2020, providers will be required to obtain preauthorization through Blue Cross and Blue Shield of New Mexico (BCBSNM), Optum, or eviCore for certain procedures for Blue Cross Medicare Advantage members as noted in the MAPD Benefit Preauthorization Procedure Code List, Effective 1/1/2020, below. For members NOT attributed to Optum, preauthorization should be obtained from BCBSNM unless the applicable entry in the MAPD Benefit Preauthorization Procedure Code List references eviCore. For members attributed to Optum, preauthorization should be obtained from Optum, even if the applicable entry in the MAPD Benefit Preauthorization Procedure Code List references eviCore. Any entry that references eviCore should be preauthorized through eviCore except for members attributed to Optum. The member's ID Card will indicate that the member is attributed to Optum. Services performed without benefit preauthorization may be denied for payment in whole or in part, and you may not seek reimbursement from members. Member eligibility and benefits should be checked prior to every scheduled appointment. Eligibility and benefit quotes include membership status, coverage status and other important information, such as applicable copayment, coinsurance and deductible amounts. It is strongly recommended that providers ask to see the member's ID card for current information and a photo ID to guard against medical identity theft. A referral to an out-of-plan or out-of-network provider which is necessary due to network inadequacy or continuity of care must be reviewed by the BCBSNM Utilization Management or DMG (if the member is attributed to DMG this information will be reflected on the ID card) prior to a BCBSNM patient receiving care. -
Phalloplasty and Urethral
plastol na og A y Golpanian et al., Anaplastology 2016, 5:2 Anaplastology DOI: 10.4172/2161-1173.1000159 ISSN: 2161-1173 Review Article Open Access Phalloplasty and Urethral (Re)construction: A Chronological Timeline Samuel Golpanian, Kenneth A Guler, Ling Tao, Priscila G Sanchez, Klara Sputova and Christopher J Salgado* Division of Plastic Surgery, DeWitt Daughtry Family, University of Miami, Miami, FL, USA Abstract Since the first penile reconstruction in 1936, various techniques of phalloplasty and urethroplasty have been developed. These advancements have paralleled those in the field of plastic and reconstructive surgery and offer a complex patient population the opportunity of restoration of cosmetic and psychosexual function. The continuous evolution of these methods has resulted in constant improvement of the surgical techniques in use today. Here, we aim to describe a historical overview of phalloplasty and urethral (re)construction. Keywords: Phalloplasty; Urethroplasty; Reconstruction; Transgen- gender reassignment over the next 40 years. Various fasciocutaneous der; Surgery and extended pedicle island flaps were also developed during this time. Nonetheless, they continued to have suboptimal functional and Introduction aesthetic results due to their significant limitations in sensory recovery Phalloplasty is a complex surgical task. Successful creation or primarily [10,13,14]. restoration of the penis must meet certain cosmetic and functional Throughout the 1970’s other innovations were introduced in the field thresholds. The ideal neophallus should be sensate, hairless, and similar of penile reconstruction. In 1971, Kaplan et al. [15] developed a method in color to the surrounding skin. It should have an inconspicuous scar, that provided sensation to the neophallus. -
Curative Pelvic Exenteration for Recurrent Cervical Carcinoma in the Era of Concurrent Chemotherapy and Radiation Therapy
Available online at www.sciencedirect.com ScienceDirect EJSO xx (2015) 1e11 www.ejso.com Review Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review H. Sardain a,b, V. Lavoue a,b,c,*, M. Redpath d, N. Bertheuil b,e, F. Foucher a,J.Lev^eque a,b,c a CHU de Rennes, Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, Hopital^ Sud, 16, Bd de Bulgarie, 35000 Rennes, France b Universite de Rennes, Faculty of Medicine, 2 Henry Guilloux, 35000 Rennes, France c INSERM, ER440, Oncogenesis, Stress and Signaling (OSS), Rennes, France d McGill University, Department of Pathology, Jewish General Hospital, Cote^ Sainte Catherine, Montreal, QC, Canada e CHU de Rennes, Department of Plastic, Reconstructive and Aesthetic Surgery, Tertiary Surgery Center, Teaching Hospital of Rennes, Hopital^ Sud, 16, Bd de Bulgarie, 35000 Rennes, France Accepted 26 March 2015 Available online --- Abstract Objective: Pelvic exenteration requires complete resection of the tumor with negative margins to be considered a curative surgery. The pur- pose of this review is to assess the optimal preoperative evaluation and surgical approach in patients with recurrent cervical cancer to in- crease the chances of achieving a curative surgery with decreased morbidity and mortality in the era of concurrent chemoradiotherapy. Methods: Review of English publications pertaining to cervical cancer within the last 25 years were included using PubMed and Cochrane Library searches. Results: Modern imaging (MRI and PET-CT) does not accurately identify local extension of microscopic disease and is inadequate for pre- operative planning of extent of resection. -
Understanding Icd-10-Cm and Icd-10-Pcs 3Rd Edition Download Free
UNDERSTANDING ICD-10-CM AND ICD-10-PCS 3RD EDITION DOWNLOAD FREE Mary Jo Bowie | 9781305446410 | | | | | International Classification of Diseases, (ICD-10-CM/PCS) Transition - Background Palmer B. Manual placenta removal. A: Understanding ICD-10-CM and ICD-10-PCS 3rd edition International Classification of Diseases ICD is a common framework and language to report, compile, use and compare health information. Psychoanalysis Adlerian therapy Analytical therapy Mentalization-based treatment Transference focused psychotherapy. Hysteroscopy Vacuum aspiration. Every code begins with an alpha character, which is indicative of the chapter to which the code is classified. Search Compliance Understanding BC, resilience standards and how to comply Follow these nine steps to first identify relevant business continuity and resilience standards and, second, launch a successful While many coders use ICD lookup software to help them, referring to an ICD code book is invaluable to build an understanding of the classification system. Pregnancy test Leopold's maneuvers Prenatal testing. Endoscopy : Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy. Psychosurgery Lobotomy Bilateral cingulotomy Multiple subpial transection Hemispherectomy Corpus callosotomy Anterior temporal lobectomy. While codes in sections are structured similarly to the Medical and Surgical section, there are a few exceptions. Send Feedback Do you have Understanding ICD-10-CM and ICD-10-PCS 3rd edition on the new website? Help Learn to edit Community portal Recent changes Upload file. D Radiation oncology. Stem cell transplantation Hematopoietic stem cell transplantation. The primary distinctions are:. Palmer Joseph C. -
Pelvic Exenteration for the Management of Pelvic Malignancies
Chapter 7 Pelvic Exenteration for the Management of Pelvic Malignancies Daniel Paramythiotis, Konstantinia Kofina and Antonios Michalopoulos Additional information is available at the end of the chapter http://dx.doi.org/10.5772/61083 Abstract Pelvic exenteration is a surgical procedure first described by Brunschwig in 1948 as a curative or palliative treatment for pelvic and perineal tumors. It is actually a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In patients with recurrent cervical and vaginal malignancy, it is associated with a 5-year survival of more than 50%. In spite of advances in surgical management, consequences such as stomas, are still frequently unavoidable for radical tumor excision. Most candidates for this procedure have been diagnosed with recurrent cervical cancer that has previously been treated with surgery and radiation, or radiation alone. Complications of pelvic exenteration are more severe than those of standard resection of a colorectal carcinoma, so it is not commonly performed, including wound infection, wound dehiscence (also described as burst abdomen) the creation of fistulae (perineal-fecal, uretero-vaginal, between conduit and perineal wound), urinary tract infections, perineal hernias and intestinal obstruction. Patients need to be carefully selected and counseled about risks and long-term issues related to the surgery. A comprehensive evaluation is required in order to exclude unresectable or metastatic disease. Evolution of the technique through laparoscopy and minimally invasive surgery may result in a reduction of morbidity and mortality. Keywords: Pelvic exenteration, gynecologic cancer 1. Introduction Pelvic exenteration was first described by Brunschwig and his colleagues of New York’s Memorial Hospital in 1948 [1] and was initially performed as a palliative surgical intervention © 2015 The Author(s). -
PT/OT Therapy Intake Form Required for All MSK Conditions (Including Hand) Please Use This Fax Form for NON-URGENT Requests Only
Musculoskeletal Program: PT/OT Therapy Intake Form Required for all MSK Conditions (Including Hand) Please use this fax form for NON-URGENT requests only. Failure to provide all relevant information may delay the determination. Phone and fax numbers may be found on eviCore.com under the Guidelines and Forms section. You may also log into the provider portal located on the site to submit an authorization request. URGENT (same day) REQUESTS MUST BE SUBMITTED BY PHONE Previous Reference/Auth Number (If Continued Care): Date of Submission: Place of Service: ****** Note: This is REQUIRED for WellCare Submissions ******* Service Type Requested: Physical Therapy Occupational Therapy First Name: MI: Last Name: Member ID: DOB (mm/dd/yyyy): Gender: Male Female Street Address: Apt #: City: State: Zip: PATIENT Home Phone: Cell Phone: Primary: Home Cell Member Health Plan/Insurer: First Name: Last Name: Primary Specialty: TIN: NPI: Physician Phone: Physician Fax: Address: Suite #: City: State: Zip: PROVIDER Office Contact: Ext: Email: Diagnoses: Code Description Code Description Start Date for this Request: This is a (select the most appropriate): New condition not previously treated Same/previous condition Date of initial evaluation: Date of onset of condition: Date of current findings: Primary Treatment Area: Spine: Cervical / Upper Thoracic Lower Thoracic / Lumbar / Pelvis Upper Extremity: Shoulder / Arm Elbow / Wrist / Forearm Hand Lower Extremity: Hip / Thigh Knee Ankle / Foot Other: Pelvic Pain / Incontinence Secondary Treatment Area: Spine: -
From Circumcision Injury to Penile Amputation
Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 375285, 6 pages http://dx.doi.org/10.1155/2014/375285 Review Article Traumatic Penile Injury: From Circumcision Injury to Penile Amputation Jae Heon Kim,1 Jae Young Park,2 and Yun Seob Song1 1 Department of Urology, Soonchunyang University Hospital, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea 2 Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea Correspondence should be addressed to Jae Young Park; [email protected] and Yun Seob Song; [email protected] Received 24 April 2014; Revised 16 August 2014; Accepted 16 August 2014; Published 28 August 2014 Academic Editor: Ralf Herwig Copyright © 2014 Jae Heon Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. -
MAP Preauthorization List EFF: 8/1/2017 (Updated 8/24/17)
MAP Preauthorization List EFF: 8/1/2017 (Updated 8/24/17) CPT, HCPCS Description Comment or Revenue Code Revenue Codes 0100 All inclusive room and board plus ancillary 0101 All inclusive room and board 0110 Room and Board Private (one bed) 0111 Room and Board Private (one bed) - Medical/Surgical/GYN 0113 Room and Board Private (one bed) - Pediatric 0117 Room and Board Private (one bed) - Oncology 0118 Room and Board Private (one bed) - Rehab 0119 Room and Board Private (one bed) - Other 0121 Room and Board Semiprivate (two beds) - Medical/Surgical/GYN 0123 Room and Board Semiprivate (two beds) - Pediatric 0127 Room and Board Semiprivate (two beds) - Oncology 0128 Level 1 Rehab 0129 Level 2 Rehab - acute complex 0130 Room & Board - Three and Four Beds General Classification 0131 Room & Board - Three and Four Beds Medical/Surgical/Gyn 0133 Room & Board - Three and Four Beds Pediatric 0137 Room & Board - Three and Four Beds Oncology 0138 Room & Board - Three and Four Beds Rehabilitation 0139 Room & Board - Three and Four Beds Other 0140 Room & Board - Deluxe Private General Classification 0141 Room & Board - Deluxe Private Medical/Surgical/Gyn 0143 Room & Board - Deluxe Private Pediatric 0147 Room & Board - Deluxe Private Oncology 0148 Room & Board - Deluxe Private Rehabilitation 0149 Room & Board - Deluxe Private Other 0150 Room & Board - Ward General Classification 0151 Room & Board - Ward Medical/Surgical/Gyn 0153 Room & Board - Ward Pediatric 0157 Room & Board - Ward Oncology 0158 Room & Board - Ward Rehabilitation 0159 Room & Board - -
Treating Cervical Cancer If You've Been Diagnosed with Cervical Cancer, Your Cancer Care Team Will Talk with You About Treatment Options
cancer.org | 1.800.227.2345 Treating Cervical Cancer If you've been diagnosed with cervical cancer, your cancer care team will talk with you about treatment options. In choosing your treatment plan, you and your cancer care team will also take into account your age, your overall health, and your personal preferences. How is cervical cancer treated? Common types of treatments for cervical cancer include: ● Surgery for Cervical Cancer ● Radiation Therapy for Cervical Cancer ● Chemotherapy for Cervical Cancer ● Targeted Therapy for Cervical Cancer ● Immunotherapy for Cervical Cancer Common treatment approaches Depending on the type and stage of your cancer, you may need more than one type of treatment. For the earliest stages of cervical cancer, either surgery or radiation combined with chemo may be used. For later stages, radiation combined with chemo is usually the main treatment. Chemo (by itself) is often used to treat advanced cervical cancer. ● Treatment Options for Cervical Cancer, by Stage Who treats cervical cancer? Doctors on your cancer treatment team may include: 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 ● A gynecologist: a doctor who treats diseases of the female reproductive system ● A gynecologic oncologist: a doctor who specializes in cancers of the female reproductive system who can perform surgery and prescribe chemotherapy and other medicines ● A radiation oncologist: a doctor who uses radiation to treat cancer ● A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer Many other specialists may be involved in your care as well, including nurse practitioners, nurses, psychologists, social workers, rehabilitation specialists, and other health professionals. -
114.3 Cmr: Division of Health Care Finance and Policy Ambulatory Care
114.3 CMR: DIVISION OF HEALTH CARE FINANCE AND POLICY AMBULATORY CARE 114.3 CMR 40.00: RATES FOR SERVICES UNDER M.G.L. c. 152, WORKERS’ COMPENSATION ACT Section 40.01: General Provisions 40.02: General Definitions 40.03: Service and Rate Coverage Provisions 40.04: Provisions Affecting Eligible Providers 40.05: Policies for Individual Service Types 40.06: Fees 40.07: Appendices 40.08: Severability 40.01: General Provisions (1) Scope, Purpose and Effective Date. 114.3 CMR 40.00 governs the payment rates effective April 1, 2009 for purchasers of health care services under M.G.L. c. 152, the Workers’ Compensation Act. Payment rates for services provided by hospitals are set forth in 114.1 CMR 41.00. Program policies relating to medical necessity and clinical appropriateness are determined pursuant to M.G.L. c. 152 and 452 CMR 6.00. (2) Coverage. The payment rates set forth in 114.3 CMR 40.06 are full payment for services provided under M.G.L. c. 152, § 13, including any related administrative or overhead costs. The insurer, employer and health care service provider may agree upon a different payment rate for any service set forth in the fee schedule in 114.3 CMR 40.00. No employee may be held liable for the payment for health care services determined compensable under M.G.L. c. 152, § 13. (3) Administrative Bulletins. The Division may issue administrative bulletins to clarify substantive provisions of 114.3 CMR 40.00, or to publish procedure code updates and corrections. For coding updates and correction, the bulletin will list: (a) new code numbers for existing codes, with the corresponding cross references between existing and new codes numbers; (b) deleted codes for which there are no corresponding new codes; and (c) codes for entirely new services that require pricing. -
Sl.No CGHS Treatment Procedure/Investigation List Rates for Non NABH Rates for NABH CGHS Bengaluru Rate List
CGHS Bengaluru Rate List Sl.No CGHS Treatment Procedure/Investigation Rates for Non Rates for List NABH NABH 1 Consultation OPD 135 135 2 Consultation- for Inpatients 270 270 3 Dressings of wounds 45 52 4 Suturing of wounds with local anesthesia 108 124 5 Aspiration Plural Effusion - Diagnostic 120 138 6 Aspiration Plural Effusion - Therapeutic 174 200 7 Abdominal Aspiration - Diagnostic 330 380 8 Abdominal Aspiration - Therapeutic 414 476 9 Pericardial Aspiration 342 393 10 Joints Aspiration 285 329 11 Biopsy Skin 207 239 12 Removal of Stitches 36 41 13 Venesection 124 143 14 Phimosis Under LA 1180 1357 15 Sternal puncture 173 199 16 Injection for Haemorrhoids 373 428 17 Injection for Varicose Veins 315 363 18 Catheterisation 425 500 19 Dilatation of Urethra 450 518 20 Incision & Drainage 378 435 21 Intercostal Drainage 125 144 22 Peritoneal Dialysis 1319 1517 TREATMENT PROCEDURE SKIN 23 Excision of Moles 311 357 24 Excision of Warts 279 321 25 Excision of Molluscum contagiosum 117 135 26 Excision of Veneral Warts 144 166 27 Excision of Corns 126 145 28 I/D Injection Keloid 97 112 29 Chemical Cautery (s) 99 114 TREATMENT PROCEDURE OPTHALMOLOGY 30 66 76 eyes Subconjunctival/subtenon’s injections in one 31 132 152 eyes 32 PterygiumSubconjunctival/subtenon’s Surgery injections in both 5550 6325 33 Conjunctival Peritomy 58 67 34 Conjunctival wound repair or exploration 3300 3795 following blunt trauma 35 Removal of corneal foreign body 115 132 36 Cauterization of ulcer/subconjunctival injection 69 79 in one eye 37 Cauterization of ulcer/subconjunctival -
Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy,