#GRD®

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Assortment of grenades for R&D.

GRD® [GURA® Research & Development]

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Everything You Should Know while Billing for Bariatric Surgery

Basics of Bariatric Surgery Bariatric surgery procedures are performed to treat comorbid conditions associated with morbid obesity. Two types of surgical procedures are employed. Malabsorptive procedures divert food from the stomach to a lower part of the digestive tract where the normal mixing of digestive fluids and absorption of nutrients cannot occur. Restrictive procedures restrict the size of the stomach and decrease intake. Surgery can combine both types of procedures.Bariatric procedures are performed for patients that have a diagnosis of obesity. While patients typically have associated comorbidities that should also be coded and reported, obesity remains the primary reason for the procedure. Payers may also require that a specific BMI be reported to meet coverage criteria. ICD-10-CM also provides codes specifically for complications of bariatric procedures. Let’s understand information required while billing for bariatric surgery.

Medicare Coverage for Bariatric Surgery While billing traditional Medicare, refer to national coverage determination for bariatric surgery. Medicare Advantage plans are required to cover at least what is covered by Traditional Medicare. Medicare Advantage plan administrators may have policies and additional requirements such as prior authorization. Open and laparoscopic Roux-en-Y gastric bypass (RYGBP), open and laparoscopic Biliopancreatic Diversion with Duodenal Switch (BPD/DS) or Gastric Reduction Duodenal Switch (BPD/GRDS), and laparoscopic adjustable gastric banding (LAGB) are covered for Medicare beneficiaries who have a body-mass index ≥ 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity. For Medicare, treatments for obesity alone remain non-covered. Supplemented fasting is not covered under the Medicare program as a general treatment for obesity. Medicare Administrative Contractors (MACs) acting within their respective jurisdictions may determine coverage of stand-alone laparoscopic sleeve gastrectomy (LSG) for the treatment of co-morbid conditions related to obesity in Medicare beneficiaries only when all of the following conditions are satisfied. The beneficiary has a body-mass index (BMI) ≥ 35 kg/m2, The beneficiary has at least one co-morbidity related to obesity, and, The beneficiary has been previously unsuccessful with medical treatment for obesity. Other Guidelines while Billing for Bariatric Surgery Commercial insurance carriers typically determine coverage for procedures based on applicable medical policies. Prior authorization may be required. There may be plan specific coverage limitations. To avoid claim denials, use payer websites/provider portal to ensure latest coverage and submission requirements are followed. Also assign a staff member to coordinate all prior authorizations. Ensure submission of clinical information is accurate and reflects requirements within the medical policy. Relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures may be required. Consider including a clear and concise letter of medical necessity to summarize how the patient has met the payer’s coverage criteria. Submit information and maintain record of authorization review progress until a coverage decision is made. The medical record must support the medical necessity of all procedures being performed. Applicable HCPCS II Codes S2900: Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) S2083: Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline A4649: Surgical supply; miscellaneous Level II HCPCS codes are primarily used to report supplies, drugs and implants that are not reported by a CPT® code. HCPCS codes are reported by the physician, hospital or DME provider that purchased the item, device, or supply. Different insurance carriers may have different payment methods for these items.

Applicable CPT Codes Gastric Bypass, Laparoscopic 43644: Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) 43645: Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption Gastric Band, Laparoscopic 43770: Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (i.e., gastric band and subcutaneous port components) Gastric Band, Revision and Removal of Band, Laparoscopic 43771: Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only 43772: Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only 43773: Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only 43774: Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components Gastric Band, Revision and Removal of Port 43887: Gastric restrictive procedure, open; removal of subcutaneous port component only 43888: Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only Sleeve Gastrectomy 43775: Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43842: Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty Biliopancreatic Diversion without Duodenal Switch 43632: Gastrectomy, partial, distal; with gastrojejunostomy Biliopancreatic Diversion with Duodenal Switch 43845: Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoilesostomy and ileoileostomy (50 to 100 com common channel) to limit absorption (biliopancreatic diversion with duodenal switch) Gastric Bypass, Open 43846: Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy Revision, Gastric Restrictive Procedure 43848: Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) Other Revision 43860: Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43862: Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S) 43659: Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty 43999: Gastrectomy, partial, distal; with gastrojejunostomy 44799: Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoilesostomy and ileoileostomy (50 to 100 com common channel) to limit absorption (biliopancreatic diversion with duodenal switch) 44238: Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy CPT® is a registered trademark of the American Medical Association.

Legion Healthcare Solutions is a reliable medical billing company providing complete medical billing and coding services. We shared all necessary information required for billing for bariatric surgery. You are advised to refer patient insurance coverage and payer guidelines for detailed understanding. You can hire our billing and coding services to receive more insurance reimbursements while staying compliant with payer-specific and state-specific guidelines. To know more about billing and coding services, contact us at 727-475-1834 or email us at info@legionhealthcaresolutions.com

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FLRN: This Floater ETF Looks Decent, Unless There's A Credit Crisis (NYSEARCA:FLRN)

FLRN: This Floater ETF Looks Decent, Unless There’s A Credit Crisis (NYSEARCA:FLRN)

aamorim/E+ via Getty Images By Rob Isbitts Summary SPDR® Blmbg Inv Grd Flt Rt ETF (NYSEARCA:FLRN) looks simple and attractive at first glance. In this era of rising rates, why not own an ETF whose holdings are bonds with rates that rise with rising interest rates? Because it is not that simple. Corporate bonds are a different animal from US Treasuries. That adds a level of complexity and…

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I am an image transcribing bot which uses Tesseract OCR to translate images to text. I'm far from perfect but I try my best! If I sound pleased about this, it's only because my programmers made this my default tone of voice! I'm actually quite depressed! | PayPal | Patreon

I just want to bring this to everyone’s attention… This is from the pokemon gold and silver demo which was released two years before the game itself. look at all of these scrapped/altered pokemon!!

There’s also a google sheet with information about the game and those behind this!!! I definitely reccomend you check it out if you want to learn more/are interested in the rom! :>

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Everything You Should Know while Billing for Bariatric Surgery

Basics of Bariatric Surgery Bariatric surgery procedures are performed to treat comorbid conditions associated with morbid obesity. Two types of surgical procedures are employed. Malabsorptive procedures divert food from the stomach to a lower part of the digestive tract where the normal mixing of digestive fluids and absorption of nutrients cannot occur. Restrictive procedures restrict the size of the stomach and decrease intake. Surgery can combine both types of procedures.Bariatric procedures are performed for patients that have a diagnosis of obesity. While patients typically have associated comorbidities that should also be coded and reported, obesity remains the primary reason for the procedure. Payers may also require that a specific BMI be reported to meet coverage criteria. ICD-10-CM also provides codes specifically for complications of bariatric procedures. Let’s understand information required while billing for bariatric surgery.

Medicare Coverage for Bariatric Surgery While billing traditional Medicare, refer to national coverage determination for bariatric surgery. Medicare Advantage plans are required to cover at least what is covered by Traditional Medicare. Medicare Advantage plan administrators may have policies and additional requirements such as prior authorization. Open and laparoscopic Roux-en-Y gastric bypass (RYGBP), open and laparoscopic Biliopancreatic Diversion with Duodenal Switch (BPD/DS) or Gastric Reduction Duodenal Switch (BPD/GRDS), and laparoscopic adjustable gastric banding (LAGB) are covered for Medicare beneficiaries who have a body-mass index ≥ 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity. For Medicare, treatments for obesity alone remain non-covered. Supplemented fasting is not covered under the Medicare program as a general treatment for obesity. Medicare Administrative Contractors (MACs) acting within their respective jurisdictions may determine coverage of stand-alone laparoscopic sleeve gastrectomy (LSG) for the treatment of co-morbid conditions related to obesity in Medicare beneficiaries only when all of the following conditions are satisfied. The beneficiary has a body-mass index (BMI) ≥ 35 kg/m2, The beneficiary has at least one co-morbidity related to obesity, and, The beneficiary has been previously unsuccessful with medical treatment for obesity. Other Guidelines while Billing for Bariatric Surgery Commercial insurance carriers typically determine coverage for procedures based on applicable medical policies. Prior authorization may be required. There may be plan specific coverage limitations. To avoid claim denials, use payer websites/provider portal to ensure latest coverage and submission requirements are followed. Also assign a staff member to coordinate all prior authorizations. Ensure submission of clinical information is accurate and reflects requirements within the medical policy. Relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures may be required. Consider including a clear and concise letter of medical necessity to summarize how the patient has met the payer’s coverage criteria. Submit information and maintain record of authorization review progress until a coverage decision is made. The medical record must support the medical necessity of all procedures being performed. Applicable HCPCS II Codes S2900: Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) S2083: Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline A4649: Surgical supply; miscellaneous Level II HCPCS codes are primarily used to report supplies, drugs and implants that are not reported by a CPT® code. HCPCS codes are reported by the physician, hospital or DME provider that purchased the item, device, or supply. Different insurance carriers may have different payment methods for these items.

Applicable CPT Codes Gastric Bypass, Laparoscopic 43644: Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) 43645: Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption Gastric Band, Laparoscopic 43770: Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (i.e., gastric band and subcutaneous port components) Gastric Band, Revision and Removal of Band, Laparoscopic 43771: Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only 43772: Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only 43773: Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only 43774: Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components Gastric Band, Revision and Removal of Port 43887: Gastric restrictive procedure, open; removal of subcutaneous port component only 43888: Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only Sleeve Gastrectomy 43775: Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43842: Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty Biliopancreatic Diversion without Duodenal Switch 43632: Gastrectomy, partial, distal; with gastrojejunostomy Biliopancreatic Diversion with Duodenal Switch 43845: Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoilesostomy and ileoileostomy (50 to 100 com common channel) to limit absorption (biliopancreatic diversion with duodenal switch) Gastric Bypass, Open 43846: Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy Revision, Gastric Restrictive Procedure 43848: Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) Other Revision 43860: Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43862: Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S) 43659: Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty 43999: Gastrectomy, partial, distal; with gastrojejunostomy 44799: Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoilesostomy and ileoileostomy (50 to 100 com common channel) to limit absorption (biliopancreatic diversion with duodenal switch) 44238: Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy CPT® is a registered trademark of the American Medical Association.

Legion Healthcare Solutions is a reliable medical billing company providing complete medical billing and coding services. We shared all necessary information required for billing for bariatric surgery. You are advised to refer patient insurance coverage and payer guidelines for detailed understanding. You can hire our billing and coding services to receive more insurance reimbursements while staying compliant with payer-specific and state-specific guidelines. To know more about billing and coding services, contact us at 727-475-1834 or email us at info@legionhealthcaresolutions.com