Beacon

Current Prepayment Medical Review Log

The table below provides you with a list of the most current prepayment reviews being conducted by the Part A Medical Review Department.  This is not an all inclusive list.

February 2017

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5201K – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5200K – Alabama
5042R – Georgia
5038N– Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
50

January 2017

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5201K – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5200K – Alabama
5042R – Georgia
5038N– Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
50

December 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5201K – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5200K – Alabama
5042R – Georgia
5038N– Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

 

November 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

 

October 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

 

September 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

 

August 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

July 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

June 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

May 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

April 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

March 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

February 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Tennessee

January 2016

Review Description Bill Type Edit Number(s)
Inpatient Rehab Facility A0801-A0804 11X 5176K – Alabama
5014R – Georgia
5009N – Tennessee
Neurological CMGs A0601 – A0604, D0601 – D0604 11X 5197K– Alabama
Inpatient Rehab A2001-A2004 11X 5177K – Alabama
5015R – Georgia
5010N – Tennessee
CPT 83880 – B-type Natriuretic Peptide 14X 5134K – Alabama
5010R – Georgia
5004N – Tennessee
Inpatient Rehab Facility D0801- D0804 Facility type code 3 or T (IRFs and IRUs) 11X 5218V – Alabama
CPT 83880- B- type Natriuretic Peptide (BNP) with HCPCS modifier L1 13X 5219V – Alabama
5066Q – Georgia
5066T – Tennessee
CPT 22513 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic) and/ or CPT 22514 (Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), one vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar) 13X 5198K-Alabama
5038R-Georgia
5031N-Ten

Archive

Prepayment Medical Review Logs are archived for the following years:

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