Gastroenterology Coding Alert

Quick quiz: Is level 1 general or direct supervision? You can finally crack the Medicare Physician Fee Schedule code ' and know when you can report certain gastroenterology services ' by keeping this list of physician supervision levels close by. The lowdown: The MPFS notes supervision levels in number format (such as 1, 2 and so on). You can find supervision level explanations in Medicare's IOM 100-02 Medicare Benefit Policy Manual, Chapter 15, Section 80, says Kathy Pride, CPC, director of government program services with QuadraMed in Reston, Va. Physician Supervision/Diagnostic Indicator (Phys Supv) 0 -- Procedure is not a diagnostic test, or procedure is a diagnostic test which is not subject to the physician supervision policy. 1 -- Procedure must be performed under the general supervision of a physician. 2 -- Procedure must be performed under the direct supervision of a physician. 3 -- Procedure must be performed under the personal supervision of a physician. 4 -- Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist or a clinical psychologist or furnished under the general supervision of a clinical psychologist; otherwise must be performed under the general supervision of a physician. 5 -- Physician supervision policy does not apply when procedure is furnished by a qualified audiologist; otherwise must be performed under the general supervision of a physician. 6 -- Procedure must be performed by a physician or by a physical therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiologic clinical specialist and is permitted to provide the procedure under State law. 6a -- Supervision standards for level 66 apply; in addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill. 7a -- Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill. 9 -- Concept does not apply. 21 -- Procedure must be performed by a technician with certification under general supervision of a physician; otherwise must be performed under direct supervision of a physician. 22 -- Procedure may be performed by a technician with on-line real-time contact with physician. 66 -- Procedure must be performed by a physician or by a PT with ABPTS certification and certification in this specific procedure. 77 -- Procedure must be performed by a PT with ABPTS certification or by a PT without certification under direct supervision of a physician, or by a technician with certification under general supervision of a physician.