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  • Billing tip: Botox injections for chronic migraine sufferers | Alberta Medical Association
    number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips Billing tip Botox injections for chronic migraine sufferers Billing Tip Botox injections for chronic migraine sufferers 13 59O Botox injections for chronic migraine sufferers may now be submitted to the Alberta Health Care Insurance Plan AHCIP using HSC 13 59O Botox treatment may be used for chronic migraine sufferers for persons aged 18 to 65 who suffer from migraines more than 15 times a month and have been recommended for this treatment by their physician Follow up treatment may be claimed in 12 week intervals Only one call may be claimed regardless of the number of injections performed May be claimed in addition to a visit or consultation when appropriate Services for patients under the age of 18 or more than 65 years of age must be billed directly to the patient as this is considered an uninsured service by Alberta Health Patients may be charged for the Botox following the College of Physicians Surgeons of Alberta Standards of Practice Standard 13 Dispensing of Schedule 1 or 2 drugs by a physician for a fee The Botox injections for migraines may be claimed in addition to a visit or consultation as appropriate However the time spent performing the injections may not be included in the time claimed for complex modifiers or prolonged visits consultations For more information on the management of headaches please visit the Toward Optimized Practice website For more advice from AMA staff on any billing issues including explanations of recent billing changes please email AMA billing staff Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/billing-tip-botox (2016-02-01)
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  • Claims for the nasal flu mist, flu and pneumonia injections | Alberta Medical Association
    flu vaccine may receive the vaccine via nasal mist or spray Alberta Health has advised that the administration of the nasal flu mist may be submitted to the Alberta Health Care Insurance Plan AHCIP as HSC 03 02A brief visit if the physician provides the service If the physician provided a visit service as well as the nasal mist vaccine on the same day only one visit may be claimed 03 03A 03 04A as appropriate Chart notes should reflect that a visit and vaccine service occurred If the nurse provided the vaccine and no other services were provided nothing may be claimed to AHCIP for the mist 13 59A Flu and pneumonia vaccine reminders injections Flu and pneumonia vaccine season is fast approaching Here are some reminders 13 59A may be claimed in addition to a visit when the physician provides a visit service in accordance with the Governing Rules In order to claim for more than one injection at the same encounter simply change the number of calls to the appropriate number If more than two injections are provided at the same encounter text must be added to the claim For injections provided in the physician s office Injections for flu or pneumonia may be claimed as 13 59A when the nurse provides the injections Bulletin MED 97 A visit service may not be claimed in addition to a nurse provided injection unless the physician has provided a visit service in accordance with the Governing Rules Nurse provided injections in the hospital may not be submitted by a physician to Alberta Health for payment The only injections that are billable to Alberta Health when they are provided by the nurse are for flu pneumonia 13 59A and allergy desensitization 13 42A All other injections must be provided by

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/billing-tip-flu (2016-02-01)
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  • Multiple 13.59A injections at the same encounter | Alberta Medical Association
    paperwork Resident Physicians Medical Students Membership Guide Manage your membership Patients First Advocacy timeline Health issues Prescription Alberta Many Hands Physician Advocacy Immunization Other Patient Health Matters albertapatients Forms Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips Multiple 13 59A injections at the same encounter Multiple 13 59A injections at the same encounter If you are providing multiple injections at the same encounter you would Submit one claim to AHW for payment Enter the number of injections provided in the calls field More than two calls must be submitted with text stating the types of injections performed Injections using HSC 13 59A for flu and or pneumonia vaccination may be submitted when they are provided by the nurse However all other injections using HSC 13 59A must be provided by the physician in order to be eligible for payment Please note that tetanus shots are only billable to AHW when they are administered by the physician as a part of wound management All other tetanus shots initial or booster should be referred to a public health clinic Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016 stat holidays WCB report fee adjustments coming April 1 and July 1 2016 Billing seminars Compensation programs Uninsured services Allocation Alternative Relationship Plans ARPs Economic indicators WCB Physician and

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/multiple-injections (2016-02-01)
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  • Changes to the Interim Federal Health Program | Alberta Medical Association
    Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips Changes to the Interim Federal Health Program Changes to the Interim Federal Health Program Effective June 30 there will be changes to benefits covered by the Interim Federal Health Program IFHP as outlined on the Citizenship and Immigration Canada website The Alberta Medical Association AMA is working with the Canadian Medical Association and physician groups to identify the negative implications these changes will have on a disadvantaged patient population and the longer term effects on health care costs The AMA will be discussing these concerns with the provincial health minister Some notable changes are listed below Complete elimination of all dental vision ambulatory and pharmacy care Hospital services care of doctors and nurses and laboratory diagnostic or ambulance care are only covered if urgent or essential in nature Medications and vaccines will only be covered in the case of a public health or safety concern The IFHP was originally created to provide temporary health coverage for refugee claimants and others under immigrant control These changes come as a result of the direction set in the 2012 federal budget For more information please contact the program administrator Medavie Blue Cross 1 888 614 1880 For information on how to process IFHP claims please refer to the February 24 2011 issue of MD Scope Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/interim-federal-health-program-news (2016-02-01)
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  • Are you using the BMI modifier correctly? | Alberta Medical Association
    PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management Do the paperwork Resident Physicians Medical Students Membership Guide Manage your membership Patients First Advocacy timeline Health issues Prescription Alberta Many Hands Physician Advocacy Immunization Other Patient Health Matters albertapatients Forms Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips Are you using the BMI modifier correctly Are you using the BMI modifier correctly Make sure to record the BMI modifier correctly on all applicable claims that are submitted for the patient Some physicians are only entering BMI into the modifier field This is not a valid modifier and will not result in payment of the additional 25 The correct modifier to enter into the modifier field for the role of the surgeon is BMISRG For claims for surgical assist two modifiers must be entered SA into one field and BMISRG into another field The appropriate BMI modifiers for anesthesia are as follows choose one as appropriate BMIANE BMIANT BMI2AN BMIABD Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016 stat holidays WCB report fee adjustments coming April 1 and July 1 2016 Billing seminars Compensation programs Uninsured services Allocation Alternative Relationship Plans ARPs Economic indicators WCB Physician and Family Support Program PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/bmi-modifier (2016-02-01)
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  • Claiming the BMI modifier for procedures | Alberta Medical Association
    for procedures Did you know that effective April 1 2015 the BMI modifier changed from its previous BMISRG to the new BMIPRO The New BMIPRO modifier is used in place of the BMISRG and it is billable for eligible services provided in any location including the physician s office when the patient has met the criteria for BMI a An adult patient has a body mass index of 35 or more b A patient under 18 years of age who is above the 97th percentile for BMI on an approved pediatric growth curve The new code 13 99BC for pap smear and or pelvic swab using a speculum was added to the list of codes that are eligible for BMIPRO To find out whether or not a procedure has a BMIPRO modifier you may consult Price List of the Schedule of Medical Benefits http www health alberta ca professionals SOMB html Use the Ctrl F to open up the search bar and enter in the fee code and review the Price List You may also try the AMA Fee Navigator www albertadoctors org feenav type the fee code into the search bar and review the Price List Procedures that were previously listed as having BMISRG may still be submitted for additional payment using the BMIPRO modifier Anesthetic services should be submitted using the same modifiers as always using BMIANT BMIANE as appropriate for eligible services provided in any location local anesthetic excluded Additional information Claims for services that were provided before April 1 2015 MUST be submitted using BMISRG under the previous criteria The following HSCs are only eligible for the BMI modifier when the service is provided under general spinal epidural anaesthetic or regional nerve block performed in an operating room day surgery or surgical suite 98 11A 98

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/claiming-the-bmi-modifier (2016-02-01)
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  • CMGP and procedures | Alberta Medical Association
    Support Program PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management Do the paperwork Resident Physicians Medical Students Membership Guide Manage your membership Patients First Advocacy timeline Health issues Prescription Alberta Many Hands Physician Advocacy Immunization Other Patient Health Matters albertapatients Forms Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips CMGP and procedures CMGP and procedures The time spent completing a procedure for a patient cannot be used to calculate the time for the CMGP modifier For example a patient might ask a physician to examine a sebaceous cyst and the physician decides to excise the cyst If the time spent examining the cyst was under 15 minutes and the time removing the cyst took 25 minutes the claim to the Alberta Health Care Insurance Plan would use health service codes 03 03A and 98 12C The complexity modifier could not be claimed as the time spent delivering the visit portion of the service was under 15 minutes Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016 stat holidays WCB report fee adjustments coming April 1 and July 1 2016 Billing seminars Compensation programs Uninsured services Allocation Alternative Relationship Plans ARPs Economic indicators WCB Physician and Family Support Program PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management Do

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/cmgp-and-procedures (2016-02-01)
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  • CMGP modifier | Alberta Medical Association
    Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips CMGP modifier CMGP modifier The complex modifier CMGP compensates physicians for a number of activities not just for time spent face to face The time to calculate the modifier includes the following activities which must be completed on the same date of service the patient was seen Writing a referral letter Charting Reviewing the chart Reviewing but not waiting for lab DI results Talking with and examining the patient Anything else the physician does in relation to the patient s care The CMGP modifier can only include the physician s time and not the time of other facility or office staff The CMGP modifier applies to HSC s 03 01J 03 03A 03 03B 03 03C 03 03N 03 03P 03 03Q 03 07A and 03 07B The CMGP modifier can also be claimed as appropriate in any location CMGP may only be claimed when the full amount of time is expended per unit The first unit is claimed when 15 minutes has elapsed and subsequent units may not be claimed until a full minute has elapsed The following are the time increments for billing CMGP 0 14 minutes Visit only 15 24 minutes Visit CMGP01 25 34 minutes Visit CMGP02 35 44 minutes Visit CMGP03 45 54 minutes Visit CMGP04 55 59 minutes Visit CMGP05 65 74 minutes Visit CMGP06 75 84 minutes Visit CMGP07 85 94 minutes Visit CMGP08 95 104 minutes Visit CMGP09 105 minutes or more Visit CMGP10 Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/cmgp-modifier (2016-02-01)
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