ForwardHealth Update 2009-58 - ForwardHealth Portal
ForwardHealth Update 2009-58 - ForwardHealth Portal
ForwardHealth Update 2009-58 - ForwardHealth Portal
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Procedure<br />
Code<br />
Description Modifier<br />
69620 Repair of Eardrum $<strong>58</strong>3.72<br />
69631 Repair Eardrum Structures $751.61<br />
69632 Rebuild Eardrum Structures $924.34<br />
69633 Rebuild Eardrum Structures $890.19<br />
69635 Repair Eardrum Structures $1,045.62<br />
69641 Revise Middle Ear & Mastoid $895.96<br />
69642 Revise Middle Ear & Mastoid $1,156.44<br />
69643 Revise Middle Ear & Mastoid $1,056.18<br />
69644 Revise Middle Ear & Mastoid $1,276.69<br />
69660 Revise Middle Ear Bone $803.54<br />
69930 Implant Cochlear Device $1,083.34<br />
90935 Hemodialysis, One Evaluation $63.86<br />
90937 Hemodialysis, Repeated Eval $105.04<br />
90945* Dialysis, One Evaluation $66.35<br />
90947 Dialysis, Repeated Eval $107.50<br />
91010 Esophagus Motility Study $171.75<br />
91010 26 $63.91<br />
91010 TC $107.84<br />
91065 Breath Hydrogen Test $<strong>58</strong>.81<br />
91065 26 $10.02<br />
91065 TC $48.79<br />
91110 GI Tract Capsule Endoscopy $814.60<br />
91110 26 $183.47<br />
91110 TC $627.84<br />
91122 Anal Pressure Record $210.10<br />
91122 26 $86.35<br />
91122 TC $123.75<br />
92225 Special Eye Exam, Initial $21.82<br />
92235 Eye Exam with Photos $108.45<br />
92235 26 $40.47<br />
92235 TC $67.98<br />
92286 Internal Eye Photography $101.46<br />
92286 26 $32.40<br />
92286 TC $69.05<br />
92<strong>58</strong>5 Auditor Evoke Potent, Compre $89.97<br />
92<strong>58</strong>5 26 $24.45<br />
92<strong>58</strong>5 TC $65.51<br />
92960 Cardioversion Electric, Ext $239.96<br />
New Reimbursement<br />
Rate<br />
<strong>ForwardHealth</strong> Provider Information October <strong>2009</strong> No. <strong>2009</strong>-<strong>58</strong> 18
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