Due to the Public Health Emergency (PHE) on March 26, 2020, TPE reviews were temporarily postponed because of the 2019 Novel Coronavirus (COVID-19). Below is the TPE historical data from reviews that occurred for Medical Review Part B prior to the March 26, 2020 postponement. For current TPE activities click here.
All prior topics with completed TPE round reviews are listed below with their historical results.
Evaluation and Management (E/M): Initial Hospital Services (CPT 99221-99223)
JL Results
JH Results
Ambulance Services: Non-Emergent Basic Life Support (BLS) Transport (HCPCS Codes A0428 and A0425)
E/M: Critical Care Services (CPT 99291 and 99292)
Psychiatric Services: Psychotherapy (CPT 90832-90838)
E/M: Subsequent Hospital Services (CPT 99231-99233)
Laboratory Services: Presumptive and Definitive Drug Testing (CPT 80307; HCPCS G0480-G0483)
E/M: Subsequent Nursing Facility Services (CPT 99307-99310)
E/M: Initial Nursing Facility Services (CPT 99304-99306)
Drugs and Biologicals: Drug Injections (HCPCS J2778, J2505, J0897, J0178, J1745 and administrative codes billed with drug)
E/M: Initial Office/Outpatient Services (CPT 99201-99205)
Rehabilitation Services: Outpatient Physical and Occupational Therapy(CPT 97010-97546)
E/M: Established Office/Outpatient Services (CPT 99212-99215)
E/M: Chronic Care Management (CCM) (CPT 99490-99489), Transitional Care Management (CPT 99495-99496) and Advance Care Planning (ACP) (CPT 99497-99498)
E/M: Emergency Room Services (CPT 99281-99285)
Drug and Biologicals: Herceptin (HCPCS J9355)
E/M: Home Services (CPT 99347-99350)
E/M: Critical Care Service (CPT 99291-99292) and High-Level Emergency Room Service (CPT 99284-99285) Billed Same Day
E/M: Hospital Discharge Services (CPT 99238-99239)
Paravertebral Facet Joint Injections (CPT 64490-64492)
E/M: Initial Hospital Observation Services (CPT 99218-99220)
Surgical Services: Nail Debridement/Paring or Cutting of Hyperkeratotic Lesions (CPT 11720-11721; 11055-11057)
Surgical Services: Cataract Extraction (CPT 66982-66984)
End Stage Renal Disease (ESRD) Services (CPT 90960-90961)
Loading...
