Allowance. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. Your MCD session is currently set to expire in 5 minutes due to inactivity. AHA copyrighted materials including the UB‐04 codes and <> The views and/or positions presented in the material do not necessarily represent the views of the AHA. 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. You can collapse such groups by clicking on the group header to make navigation easier. This section showsAPC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Iowa Kansas Missouri Nebraska, Jurisdiction 6 If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Feetool. code. 3HUZLSUh0hc09+`LH4 0v=S``4$}Jz 44~F 0 m]~|g-!Q:n"e~(pI>L^|e2,FP WqHG9 2SsQ_ ,v%X6Y]6ih`g,J"YLq,J*YUb These costs are a guideline of what you may be charged for this particular CPT code, but of course your results may vary. Could really use some help in understanding when screening codes can be used. THE UNITED STATES The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES "dDXlUA@ 5+[^]+/QXmd "U`;-j `8m Draft articles have document IDs that begin with "DA" (e.g., DA12345). Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT code. All Rights Reserved. 0000008060 00000 n These codes should not be used to report urine drug testing for illicit use of these drugs. 0000007318 00000 n I was just wondering if any are bundled. I have started working for a hospital OP lab. 81001 This email will be sent from you to the 0000003007 00000 n 0000000016 00000 n Request a Demo 14 Day Free Trial Buy Now Additional/Related Information Lay Term All rights reserved. 7500 Security Boulevard, Baltimore, MD 21244. The scope of this license is determined by the AMA, the copyright holder. View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. You will be able to see the most common modifiers billed to Medicare along with this code. x]Y6~W6&q$Z-HT]}U.E1#/H ?$Wj}Lq\%|;w|yy~us]v?vf''=WdEE[}g/ IV"~X$~X$7-JX_fyV,6j o 5 H3_c, A(|%Io`H 4-+KD72R7rB4|BH Please click Continue to leave this website. 0000002827 00000 n ), Related CPT CodeBook Guidelines (Reverse Guideline Lookup). While every effort is made to provide information that is up-to-date, policy updates take place frequently and, as a result, retaining/using a printed version may not represent the most current information. 0000002784 00000 n 0000009347 00000 n Request a Demo 14 Day Free Trial Buy Now Additional/Related Information Lay Term 512 0 obj<> endobj Available for over 5000 of the most common CPT codes. For multiplex antibody stain procedure, use CPT 88344. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Not offered in Quest Diagnostics Nichols Institute (IFD) - San Juan Capistrano. Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; All Rights Reserved. The service is medically necessary. If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. 0000003649 00000 n 82728 "JavaScript" disabled. Every vignette contains a Clinical Example/Typical Patient and a description of Procedure/Intra-service. 2 0 obj inI$.n[Mdce'a)cw 1K{_W |Z)Qpu,; 3 H?*YlwgegRK}T~#l?^1?hj_Z mQ Iq*,{f_sHx @o{0gp#i^|)BB/ LN_Zkv"\I0kfLi]7-eWES[ { Lr5G%;=\fEX}%t{.;2L:l.2ie6lCG Sign up to get the latest information about your choice of CMS topics in your inbox. Instructions for enabling "JavaScript" can be found here. It is particularly useful in detecting occult infections, acute appendicitis, particularly in leukemia and in postoperative patients. endstream endobj 513 0 obj<> endobj 514 0 obj<> endobj 516 0 obj<>/Font<>>>/DA(/Helv 0 Tf 0 g )>> endobj 517 0 obj<> endobj 518 0 obj<> endobj 519 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>> endobj 520 0 obj<> endobj 521 0 obj<> endobj 522 0 obj<> endobj 523 0 obj<> endobj 524 0 obj<> endobj 525 0 obj<> endobj 526 0 obj<>stream All Rights Reserved (or such other date of publication of CPT). T&G19QOPQ)Gz#n&mXMhWAy7 "?%lDO{Tm>sr? Viewhistorical information about the code including when it was added, changed, deleted, etc. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. 0000007528 00000 n HWv6)% %BN;3vB4$-M_d@YKT$q$s(>O|<8STb-05n,ru|v(%_ol@|!`5.Iuq#04a>>T:a3>$C;..2YOa8"yHyp`ZVKA%ED(mC %&' !l8`QNz5-S3;4"&}(M;\VXEWuyG7_*yJo|F{]lZGw${U]1$XuG7J0.y.9l,83Yj9L0F\l$ ]H^zwnb5N)/se. But they don't code 1R:y8gmeQy(ECB)@}FM"f'71dj-P?PKQBJ"K+8*lkti:&$y {W aLEEJDLRdj:ZD*@^as.:7ha0Qpg>R!v.1yl8XXM_($lAC#L`B)l7S *5)frv4(zhd'C]` "E-Y]U|\cMdw-y"a+z3(PsiGAORRdHIW~DH(`!(:E0G(c3 !f``@|@d4hv# LSx4-X8'aPe`[X(eb`m Alaska Arizona Idaho Montana North Dakota Oregon South Dakota Utah Washington Wyoming, Jurisdiction H CPT codes are provided here for the convenience of our clients; however, correct coding often varies from one carrier to another, and HealthLab may bill specific carriers using codes other than . Providers are reminded that not all CPT/HCPCS codes listed can be billed with all Bill Type and/or Revenue Codes listed. 80053 An asterisk (*) indicates a If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. 0000010995 00000 n Description Obs Mean Std Dev C.V. 5th 25th 50th 75th 95th IQR PM Pts . Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). See also: The Right Time for Billing Codes 15 Minute Codes For CPT codes designated as 15 minutes, multiple coding represents minimum face-to-face treatment, as follows 1 unit: 8 minutes to 22 minutes endstream endobj 527 0 obj<> endobj 528 0 obj<> endobj 529 0 obj<> endobj 530 0 obj<> endobj 531 0 obj<> endobj 532 0 obj<> endobj 533 0 obj<> endobj 534 0 obj<> endobj 535 0 obj<> endobj 536 0 obj<> endobj 537 0 obj<> endobj 538 0 obj<> endobj 539 0 obj<> endobj 540 0 obj<> endobj 541 0 obj<> endobj 542 0 obj<> endobj 543 0 obj<> endobj 544 0 obj<> endobj 545 0 obj<> endobj 546 0 obj<> endobj 547 0 obj<> endobj 548 0 obj<> endobj 549 0 obj<> endobj 550 0 obj<> endobj 551 0 obj<> endobj 552 0 obj<> endobj 553 0 obj<> endobj 554 0 obj<> endobj 555 0 obj<> endobj 556 0 obj<> endobj 557 0 obj<> endobj 558 0 obj<> endobj 559 0 obj<> endobj 560 0 obj<> endobj 561 0 obj<> endobj 562 0 obj<> endobj 563 0 obj<> endobj 564 0 obj<> endobj 565 0 obj<> endobj 566 0 obj<> endobj 567 0 obj<> endobj 568 0 obj<> endobj 569 0 obj<> endobj 570 0 obj<> endobj 571 0 obj<> endobj 572 0 obj<> endobj 573 0 obj<> endobj 574 0 obj<> endobj 575 0 obj<> endobj 576 0 obj<> endobj 577 0 obj<> endobj 578 0 obj<> endobj 579 0 obj<> endobj 580 0 obj<> endobj 581 0 obj<> endobj 582 0 obj<> endobj 583 0 obj<> endobj 584 0 obj<> endobj 585 0 obj<> endobj 586 0 obj<> endobj 587 0 obj<> endobj 588 0 obj<> endobj 589 0 obj<> endobj 590 0 obj<> endobj 1 0 obj<> endobj 2 0 obj<>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>> endobj 3 0 obj<>stream $35.92. View matching HCPCS Level II codes and their definitions. % CPT Code: 86140 Description: Measurement C-reactive protein for detection of infection or inflammation If you're interested to see what doctor's in your area are charging for this particular CPT code enter your zipcode in the box below and a list of doctor's known to perform this service charge will appear MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. The COVID19 pandemic and nationwide shutdown that started in March 2020 placed a spotlight on crisis preparedness within the U.S. hea Qualitative or Semiquantitative Immunoassays, Copyright 2023. CPT code information is copyright by the AMA. CMS believes that the Internet is Applicable FARS\DFARS Restrictions Apply to Government Use. 3 0 obj 0000009480 00000 n CPT: Powerful terminology for health care today and tomorrow Coding guidance for approved COVID-19 vaccine & booster codes Use AMA tool to find COVID-19 vaccine CPT codes E/M revisions to code descriptors & guidelines for 2021-2023 CPT Products CPT Developer Program: Access CPT content to build & test innovations CPT solutions and licensing 87004 r gQRYs8Wsix-,z"EdC9u rA=&5Jj' It may also be helpful in evaluating extension or reinfarction after myocardial infarction, and in following response to therapy in rheumatic disorders. NOTE: PRINTING THE MEDICAL NECESSITY INFORMATION. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration 0000010010 00000 n :p-XEo\ubnbKeX]3MWW4nmin4JcDb/=ib3Q^z$ 12B#XR8@n`UBg{Ok>>7?4'l lQV_L)y`\7>W\;|N -'>>=F;4TzT|Fr"s$`dcY}6V;%Ssx=n@0!C{Oc;CAPa9<3.q+c`u`.2eWC> ""m? If your session expires, you will lose all items in your basket and any active searches. Procedure Codes Description Group 1 Codes: 0001M Infectious dis hcv 6 assays 0002M Liver dis 10 assays w/ash 0003M Liver dis 10 assays w/nash 0004M Scoliosis dna alys 0006M Onc hep gene risk classifier 0007M Onc gastro 51 gene nomogram 0008M Onc breast risk score 0009M Fetal aneuploidy trisom risk 0010M Onc prostate prob score 81161 - 81479 Dmd dup/delet analysis - Unlisted molecular pathology Article document IDs begin with the letter "A" (e.g., A12345). 80061 New codes for laboratory tests for the novel coronavirus (COVID-19) The CMS has established new codes for laboratory tests for COVID-19. CPT coding is the sole responsibility of the billing party. Please also note that the LCD/NCD policy information is more than 700 pages in length. 0000008459 00000 n 0000009613 00000 n View the CPT code's corresponding procedural code and DRG. Please provide SERVICE AREA INFORMATION to find available tests you can order. Where appropriate, there are also Pre- and Post-service descriptions. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid .Read More Related Topic: CPT Catalog of Topics Keep your critical coding and billing tools with you no matter where you work. It seems like a lot of labs to be completed at the same visit. 0000003140 00000 n The AMA does not directly or indirectly practice medicine or dispense medical services. 300-400 new vignettes are added each year as codes added, revised and reviewed. "JavaScript" disabled. . Clinical Significance Save time with a Professional or Facility subscription! It is an acute phase reactant which rises rapidly, but nonspecifically in response to tissue injury and inflammation. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. For unlisted code 80299, a description must be provided on the claim describing the therapeutic drug which is being quantifie d. (CPT guidelines for unlisted code reporting) e. CPT code 80299 All rights reserved. American Hospital Association ("AHA"), Help needed, when can screening codes be used, Changes Are Coming for Billing Insulin in DME Pumps Under Medicare, Jury Convicts Physician for Misappropriating $250K From COVID-19 Relief, REVCON Wrap-up: Mastering the Revenue Cycle, OIG Audit Prompts ASPR to Improve Its Oversight of HPP. It is not to be used in place of CPT code 86141, which is the correct CPT code for hsCRP addressed in this LCD. 0000003263 00000 n 0000010183 00000 n You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. 0000008948 00000 n Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be w}a.=iJ. Or, if you would like to remain in the current site, click Cancel. If you would like to extend your session, you may select the Continue Button. It may help to differentiate Crohn's disease (high CRP) from ulcerative colitis (low CRP), and rheumatoid arthritis (high CRP) from uncomplicated lupus (low CRP). The Horizon name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. testing to when the result is released to the ordering provider. accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the You'll see how much the patient pays with Original Medicare and no supplement (Medigap) policy. Beginning in 2018, lab service pricing is no longer adjusted based on geographic area. The CPT codes included in this publication are in accordance with Current Procedural Terminology, a publication of the American Medical Association. 0000008858 00000 n Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, L34856 - C-Reactive Protein High Sensitivity Testing (hsCRP), Atherosclerotic heart disease of native coronary artery without angina pectoris, Hospital Inpatient (Medicare Part B only), Hospital - Laboratory Services Provided to Non-patients, Skilled Nursing - Inpatient (Medicare Part B only), Clinic - Hospital Based or Independent Renal Dialysis Center, Some older versions have been archived. It is the providers responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. reimbursement policies may use Current Procedural Terminology (CPT*), Centers for Medicare and Medicaid Services (CMS) or other coding guidelines. 0000007794 00000 n q8`^09fYf-(*19#9~y/r!w[UqEWzoi7TT rn%Ca+* \:qzx{HG'h fF79u* owdG`XEdUmGm^8MlS&/\dzVTq+^X5+Wdd1ZE{+"9z:EF.G1Jxe? 0000007231 00000 n To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom The Current Procedural Terminology (CPT ) code 86140 as maintained by American Medical Association, is a medical procedural code under the range - Qualitative or Semiquantitative Immunoassays. DISCLOSED HEREIN. The views and/or positions 80048 recipient email address(es) you enter. Code . CPT code 86140 is not to be used in place of CPT code 86141, which represents high sensitivity C-reactive protein (hsCRP) testing. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Current Dental Terminology © 2022 American Dental Association. For FREE Trial. For the purposes of this policy, a facility POS is considered POS 19, 21, 22, 23, 26, 34, 51 . 0000005091 00000 n Medicare 59 Modifiers- XE,XP,X2,XU. However, please note that once a group is collapsed, the browser Find function will not find codes in that group. The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. K lS'&!`J6-1lcMf 8eMA: % H Some articles contain a large number of codes. 87350 87086 - Culture, bacterial; quantitative colony count, urine - average fee amount - $10 - $20. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. endstream endobj 4 0 obj<>stream D(*)6rt H2AF{@0L);0eI7Ek&66ic `D`?#|8jx)dx_`:W howE|`X7cLyeYx&4,]-rX"SXXF`Mf[jL7\TWfH45ZcVO PxLDFh8^"LSW1R ASh@:W@)t"AUDX$&3d$. 0000011037 00000 n authorized with an express license from the American Hospital Association. CPT/HCPCS codes are required to be billed with specific Bill Type and Revenue Codes. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). These codes will only be considered for separate reimbursement if they are the only service billed for a date of service or if they are billed ONLY with other laboratory procedure codes for the same date of service. 0000009878 00000 n Bill a timed code only when face-to-face time spent in an evaluation is at least 51% of the time designated in the code's descriptor. End Users do not act for or on behalf of the CMS. There are multiple ways to create a PDF of a document that you are currently viewing. CRP is a pentameric globulin with mobility near the zone. For FREE Trial. The codes and allowances are shown below. To ensure the accurate and appropriate use of the information, it is recommended that the Medicare Administrative Contractor be consulted. To plug inpatient facility revenue drains, subscribe to, Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. G~}06%,VNV4 SL]UQUn 3q*8UJr+ie+``]c1O-#-jY2 <>>> 1 0 obj Subscribe to Codify by AAPC and get the code details in a flash. You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, Billing and Coding: C-Reactive Protein High Sensitivity Testing (hsCRP), AMA CPT / ADA CDT / AHA NUBC Copyright Statement, Article - Billing and Coding: C-Reactive Protein High Sensitivity Testing (hsCRP) (A56643). Subscribe to Codify by AAPC and get the code details in a flash. Diagnosis codes provided must be reflected in the patient's medical record. 0000010141 00000 n Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. End User License Agreement: %PDF-1.5 View the CPT code's corresponding procedural code and DRG. Jurisdiction 5 CPT 88341 Description: Immunohistochemistry or Immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) Use CPT 88341 in conjunction with CPT 88342. Type a procedure or code and select one from the list. Covered tests reviewed through the TA process are identified in the Molecular Diagnostic Test policy found in the LCD section. Primary sources (ie, Medicare Administrative Contractor publications, notices, and advice) should be consulted prior to the use of this information for purposes other than for submitting diagnosis codes to Labcorp. This Agreement will terminate upon notice if you violate its terms. "'2z}^Tawwz,'B#E[ {`Le!H}` UcH/D of the Medicare program. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not Please note that these forms are to be used by Federal Employee Program Members only, Referral Requirements for Services Not Related to COVID-19, Pre-Certification/Prior Authorization requirements for Post-Acute Facility Admissions, Telemedicine Cost Share Waiver for Non-COVID-19-Related Services to End, Telemedicine Cost Share Waiver for Non-COVID-19-Related Services to End for Self-Insured Health Plans, Submitting Pharmacy Claims for COVID-19 Vaccinations, Reminder: Select one method for COVID-19 and Influenza Testing, Antibody testing: FDA and CDC do not recommend use to determine immunity, June 2021 Updates: COVID-19 treatment cost share waiver, Reminder: Use correct codes when evaluating for COVID-19, Submitting claims for COVID-19 vaccines delivered in non-traditional medical settings, For Essential Workers, COVID-19 Treatment 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and Imaging Facilities, Use of Horizon Hospital Network Performance Data, Add-on Payment for COVID-19 Diagnostic Testing Run on High Throughput Technology (U0005), Ambulatory Electrocardiographic Monitoring, Bariatric Surgery Billed With Hiatal Hernia Repair, Behavioral Health Services Rendered by Supervised Practitioners, Billing Guidelines for Maternity Services, Cardiovascular Implant Device Monitoring Services, Claims Requiring Additional Documentation, Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) Supplies, COVID-19 Testing and Testing Related Services, Daily Management of Epidural or Subarachnoid Continuous Drug Administration, Daily Maximum Units for Surgical Pathology and Microscopic Examination, Distinct Procedural Service Modifiers (59, XE, XP, XS, XU), Duplicate Claim Logic for Independent Laboratory Services, Evaluation and Management Services with Chiropractic Manipulative Treatment, Evaluation and Management Services with 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Upper Respiratory Infection (URI), Avoidance of Antibiotic Treatment for Acute Bronchitis/ Bronchiolitis (AAB), Blood Pressure Control for Patients With Diabetes (BPD), Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC), Child and Adolescent Well-Care Visits (WCV), Childhood Immunization Status (CIS) (CIS-E), Colorectal Cancer Screening (COL) (COL-E), Deprescribing of Benzodiazepines in Older Adults (DBO), Depression Remission or Response for Adolescents and Adults (DRR-E), Depression Screening and Follow-Up for Adolescents and Adults (DSF-E), Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD), Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD), Eye Exam for Patients With Diabetes (EED), Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA), Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC), Follow-Up After High- Intensity Care for Substance Use Disorder (FUI), Follow-Up Care for Children Prescribed ADHD Medication (ADD-E), Hemoglobin A1c Control for Patients With Diabetes (HBD), Immunizations for Adolescents (IMA) (IMA-E), Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET), Kidney Health Evaluation for Patients with Diabetes (KED), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E), Osteoporosis Management in Women Who Had a Fracture (OMW), Osteoporosis Screening in Older Women (OSW), Persistence of Beta- Blocker Treatment After a Heart Attack (PBH), Pharmacotherapy Management of COPD Exacerbation (PCE), Postpartum Depression Screening and Follow-Up (PDS-E), Prenatal Depression Screening and Follow-Up (PND-E), Statin Therapy for Patients with Cardiovascular Disease (SPC), Statin Therapy for Patients with Diabetes (SPD), Unhealthy Alcohol Use Screening and Follow-Up (ASF-E), Use of Imaging Studies for Low Back Pain (LBP), Use of Opioids from Multiple Providers (UOP), Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR), Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), Well-Child Visits in the First 30 Months of Life (W30), Policies, Procedures and General Guidelines, Programs Administered by eviCore healthcare, Participating Physician and Other Health Care Professional Office Manual, Behavioral Health Network Specialist Assignments, Eligibility and Benefits Cost Share Estimator, Womens Health Results and Recognition Program, Provider Guidelines: Non-Standard (Medical Record) Supplemental Data for HEDIS Gap Closure, How to Submit Supplemental Data to Horizon, Health Outcomes Survey: How You Can Drive Results, Radiation Therapy Medical Necessity Determination, Pregnancy-Newborn Episodes of Care Program: Helping to Improve Outcomes for Moms and Newborns, As Mental Health Needs Continue To Rise, So Do Innovative Virtual Services, Treat Knee, Back, and Hip Pain with Orthotic Device that Helps Avoid Invasive Procedures, Horizon Neighbors in Health Program Supports Struggling Families, Bariatric Surgery Value-Based Program Helps Members with Weight Loss, Dental Providers Benefit from Dedicated Horizon Liaisons, Connecting with parents on the importance of early childhood health screenings and vaccinations, Episodes of Care Program Gives Cancer Patients the Care They Need, HealthSphere gives a behavioral health provider the full patient view, Home-Delivered Meals Help Braven Health℠ Patients, Horizon Neighbors in Health Program Helps At-Risk Members in Camden, How a value-based primary care provider helps the New Jersey Vaccination Program, Improving Health Equity through Increased Access to Prenatal Care Across New Jersey, Making Pathways in Innovating and Advancing Maternal Health, Pharmacy Collaboration leads to better patient outcomes and cost savings, Providing Innovative Cancer Care - Expanding Episodes of Care, Telehealth after COVID-19 Many doctors agree it's here to stay, Value-based care -- transforming health care with better collaboration and improved health outcomes, When planning, collaboration and crisis merge - a medical practice's successful response to COVID-19, Applicable Products:Commercial PPO/EPO &Exchange POS/EPO, Applicable Products: Commercial HMO & POS, Claims Payment Policies and Other Information.