Automated measurement of erythrocyte sedimentation rate

Description

This procedure measures the rate at which red blood cells settle in a sample of blood, providing valuable information about inflammation and other medical conditions. It is commonly used in the diagnosis and monitoring of diseases such as rheumatoid arthritis and infections.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT GWService unrelated to hospice patient's terminal condition(8.32%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(5.74%)

HCPCS/CPT 90Reference laboratory services performed by an outside laboratory(4.63%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(3.16%)

HCPCS/CPT GVAttending physician not employed by hospice provider(1.84%)

HCPCS/CPT 26Professional component of diagnostic services(1.79%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(1.47%)

HCPCS/CPT 91Repeat clinical diagnostic laboratory test performed on the same day(1.37%)

HCPCS/CPT Q4Service exemption for laboratory services by ordering/referring physician(1.21%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(0.84%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)