The professional component (see modifier -26) for radiological services is intended to cover professional services, when applicable, as listed below: 1. Determination of the problem, including interviewing the patient, obtaining the history and making appropriate...
Procedure code 76999 – there is no specific Procedure code for this service. Procedure code 76999 is for unlisted Ultrasound procedures. When performed in a hospital setting for ventilated patients in the ICU or for Operative patients with a need for ultrasound...
B. Interpretation Provided Outside of the United States Generally, Medicare will not pay for health care or supplies that are performed outside the United States (U.S.). The term “outside the U.S.” means anywhere other than the 50 states of the U.S., the District of...
Claims submitted for the global or technical component of certain ultrasound procedures when billed in combination with other ultrasound procedures for a single member within the same visit will be denied as they are considered to be included within another procedure....
Providers are compensated according to Tufts Health Plan network contracted rates regardless of the address where the service is rendered. Claims are subject to payment edits that are updated at regular intervals and generally based on Centers for Medicare &...
