Local Coverage Article Billing and Coding

Billing and Coding: Near-Infrared Spectroscopy in Wound and Flap Management

A59158

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Document Note

Posted: 1/19/2023
The original effective date for this article is 2/12/2023.

Contractor Information

Article Information

General Information

Article ID
A59158
Article Title
Billing and Coding: Near-Infrared Spectroscopy in Wound and Flap Management
Article Type
Billing and Coding
Original Effective Date
02/23/2023
Revision Effective Date
N/A
Revision Ending Date
N/A
Retirement Date
N/A
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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, §30A Services Paid Under the Medicare Physician’s Fee Schedule - Physician’s Services

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 30, §50A Advance Beneficiary Notice of Non-coverage (ABN) – General Statutory Authority – Applicability to Limitation on Liability (LOL)

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Near-Infrared Spectroscopy in Wound and Flap Management L39385.

Coding Information

CPT/HCPCS Codes

Group 1

(3 Codes)
Group 1 Paragraph

The following CPT/HCPCS codes are noncovered

Group 1 Codes
CodeDescription
0640T NONCONTACT NEAR-INFRARED SPECTROSCOPY STUDIES OF FLAP OR WOUND (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION [STO2]); IMAGE ACQUISITION, INTERPRETATION AND REPORT, EACH FLAP OR WOUND
0641T NONCONTACT NEAR-INFRARED SPECTROSCOPY STUDIES OF FLAP OR WOUND (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION [STO2]); IMAGE ACQUISITION ONLY, EACH FLAP OR WOUND
0642T NONCONTACT NEAR-INFRARED SPECTROSCOPY STUDIES OF FLAP OR WOUND (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION [STO2]); INTERPRETATION AND REPORT ONLY, EACH FLAP OR WOUND

CPT/HCPCS Modifiers

N/A

ICD-10-CM Codes that Support Medical Necessity

N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

N/A

ICD-10-PCS Codes

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

N/A

Other Coding Information

N/A

Revision History Information

N/A

Associated Documents

Related National Coverage Documents
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Statutory Requirements URLs
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Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
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Public Versions
Updated On Effective Dates Status
12/19/2022 02/23/2023 - N/A Currently in Effect You are here

Keywords

  • Wound