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Which business rules apply when processing non-physician specialties?

April 26, 2017Business physician rules specialties

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Which business rules apply when processing non-physician specialties?

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1. If the HCPCS Code is between 00100 and 01999, 95000 and 95199, 97110 and 97750, or 90780 and 97799, then the Line Service Count is set to 1. These HCPCS Codes should not appear in Non-Physician services. 2. If the HCPCS is between 77419 and 77430 and the services count is equal to 5′, then the Line Service Count is set to ‘1’. These HCPCS Codes should not appear in Non-Physician services. 3. If the Line Item is denied the Allowed Charge Amount and the Line Service Count is set to ‘0’. 4. Previous to 1995, no Ambulance Extra Mileage HCPCS Codes were in effect. In 1995, Codes A0380, A0390 and A0888 were established to depict Extra Mileage Ambulance Services. 5.