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Minor procedure documentation requirements

Surgery and Procedure Services Documentation Requirements

Medicare Surgical Guidelines • Minor surgical procedures - 0-10 day global10 day global - Include same day services • Major surgical procedures - Preoperative beginning the day before, the day of surgery - 90 day global - Related post op 17 pp - Post surgical pain management by surgeon - Any related supplies, services, or. Thinking on Paper: Documenting Decision Making. The third article in our series on Medicare's documentation guidelines will help you determine whether what's on your mind is what's on the patient. Guidelines for Teaching Physicians, Interns, and Residents MLN Booklet Page 3 of 12 ICN 006347 March 2018 Learn about these topics: Payment for physician services in teaching settings General documentation guidelines Evaluation and management (E/M) documentation guideline The most commonly used modifiers with minor procedures: 24, 25 and possibly 78 or 79 are in play. This article isn't designed to cover them, but prior OP coding articles have dealt with some of these (bit.ly/OPCoding315 , bit.ly/OPCoding715 ). Conclusion. Minor procedures have their own set of rules but are largely similar in documentation

Consider both Medicare and CPT® guidelines before billing both services using modifier 25. The issue of whether an evaluation and management (E/M) service There is no general prohibition of evaluation and management services reporting in addition to a minor surgical procedure 3. Minor Procedures. For procedures that take only a few minutes (five minutes or less) to complete, e.g., simple suture, and involve relatively little decision making once the need for the. operation is determined, the teaching surgeon must be present for the entire procedure in. order to bill for the procedure E&M documentation includes the history, exam and medical decision-making. Over the past few months, YO Info has taken a look at the three elements of the history as well as the exam. This month, we turn our focus to medical decision-making Using 1995 Documentation Guidelines 1 system 2 - 7 systems 2 - 7 systems 8 systems Using 1995 Documentation Guidelines 1 system 2-7 systems 2-7 systems 8 systems Minor surgery w/ risk factors, elective major surgery, prescription drug management, IV fluids w/ additives Removal of transvenous pacemaker Debridement of diabetic ulcer. Documentation should include, but not be limited to, induction of anesthesia, patient positioning, set-up and use of special equipment (e.g., stereotactic navigation, robot), specific brand name of any implant (s), which surgeon did what when more than one surgeon is involved, etc

For procedures performed at the same encounter as the E/M service, the above guidelines should be followed. For surgical procedures performed in the operative room or other location, consider these same seven principles as your documentation guide. An Indications for Surgery paragraph helps. Finally, make sure your documentation is legible Scenario 1: Documentation states you were in the room and provided fluoroscopic guidance 76000-26 ($8.95) Fluoroscopy only. Scenario 2: Documentation states you were not in the room but interpreted images 74328-26-52 ($18.08) Endoscopic catheterization of the biliary ductal system (Interpretation only Jun 20th, 2011 - DebraS 67. re: need documentation requirements for operative note. Our docs have at the top of the op note the patients name/dob of course. Then date of procedure, pre-dx and post-dx along with actual procedure performed (including levels, muscles, etc). Then they dictate the actual op note information below that and describe. Documentation must be dated and include a legible signature or identity. Pursuant to 42 CFR 415.172 (b), documentation must identify, at a minimum, the service furnished, the participation of the teaching physician in providing the service, and whether the teaching physician was physically present surgery/procedure/fracture care: I was present for the entire surgery/procedure/fracture care management. * (Be specific) Please note: Presence can be documented either by the resident or the TP for minor procedures. Documentation of time is not a requirement. August 28, 201

documentation for minor procedures Medical Billing and

For decades, the physician community has struggled with burdensome reporting guidelines for reporting office visits and other E/M codes. With the proliferation of electronic health records (EHRs) into physician practices, documentation requirements for office visits has moved towards increased note bloat within the patient record due to the largely check-box nature of meeting the current. The HHS regulations at 45 CFR part 46 for the protection of human subjects in research require that an investigator obtain the legally effective informed consent of the subject or the subject's legally authorized representative, unless (1) the research is exempt under 45 CFR 46.101(b); (2) the IRB finds and documents that informed consent can be waived (45 CFR 46.116(c) or (d)); or (3) the.

For example, the documentation requirements for an anesthesia practice using a care team approach — employing medical directing anesthesiologists, certified registered nurse anesthetists (CRNAs), and anesthesia assistants (AAs) — will differ from those for a practice where the anesthesiologists personally perform all procedures Minor Procedures. These reference sheets for minor procedures include common CPT ® codes, descriptions, current work and non-facility RVUs, and global days for quick reference. Global days are developed by Medicare, and published in the Medicare Fee Schedule. CMS also determines relative value units, based on recommendations from the AMA's. Name of the procedure being done: Indications: Patient consent: Document that the indications, risks and alternatives to the procedure were explained to the patient. Note that the patient was given the opportunity to ask questions and that the patient consented to the procedure in writing. Pertinent Lab Values: i.e. coags, CB

Guidelines for Nursing Documentation in Gastrointestinal Endoscopy 5 Time-out refers to a verification process done immediately before starting the procedure where procedural team members agree, at a minimum, to the correct patient, correct procedural site, and correct procedure (The Joint Commission, 2013) Review CPT surgery guidelines, modifier usage, CPT surgical package, and surgical follow up care Discuss documentation requirements for accurate CPT surgery coding Practice CPT surgery guidelines using case studies 1 Benefits from this Seminar Understand the CPT surgery guidelines in order to accurately report surgical procedures Traveling with Children. To ensure your security, all travelers are required to undergo screening. However, TSA has developed modified screening procedures for children who appear to be 12 years old and younger. TSA officers will consult parents or the traveling guardian about the best way to relieve any concerns during the screening of a child

Passport. Driver's License. Military ID. Other Government-Issued Photo ID Card. Beginning May 3, 2023, every air traveler 18 years of age and older will need a REAL ID-compliant driver's license or another acceptable form of ID. The TSA currently accepts several other forms of identity documents, such as passports, and will continue to do so. Documentation Requirements The submission of modifier -25 appended to a procedure code indicates that documentation is Since minor surgical procedures and XXX procedures include pre-procedure, intra-procedure, and post-procedure work inherent in the procedure, the provider should not report an E&M service. Documentation Guidelines for CPT E&M Codes Introduction The Current Procedural Terminology (CPT) manual, published annually by the American Medical Association (AMA) has definitive documentation guidelines that are required for each level of service code within the various E&M categories

Nursing Fundamentals II Multimedia Edition - Preoperative

Faculty AHIMA 2007 Audio Seminar Series ii Susan Von Kirchoff, MEd, RHIA, CCS, CCS-P Ms. Kirchoff has seen all sides of the healthcare environment from teacher, to coder For teaching physician rules only, a minor procedure is one that takes less than 5 minutes to complete. In order to bill for a procedure that takes less than 5 minutes, the attending must be present during the entire procedure. The attending, resident or nurse can document that the attending was present. For all other surgical procedures, the. • Minor surgery without risk factors • PT/OT • IV fluids without additives 99213 20-29 Level 4 Moderate Moderate (Must meet the requirements of at least 1 out of 3 categories) Moderate risk 99204 45-59 Moderate • 1 or more chronic illnesses with exacerbation, progression or side effects of treatment or • 2 or more stable chronic. Billing and Coding Guidelines for Wound Care LCD ID L34587 Billing Guidelines Wound Care (CPT Codes 97597, 97598 and 11042-11047) 1. Active wound care procedures are performed to remove devitalized and/or necrotic tissue to promote healing. Debridement is the removal of foreign material and/or devitalized o Coders face many challenges when coding for services provided by teaching physicians, interns, residents, and students. Medicare has specific rules and regulations surrounding what services it will pay for when an intern, a resident, or a student provides services. Lori-Lynne A. Webb, CPC, COBGC, CCS-P, CCP, CHDA, details what coders need to see in the documentation before reporting these.

DOCUMENTATION OF MEDICAL NOTES (Based on 1995 Guidelines) General Principles Medical records are legal documents. All notes must be legible and complete. The auditor will decide if they are legible. All services provided and reported to the insurer must relate to medical necessity and appropriateness The purpose of the Non-Student Minors policy is to provide guidance to faculty and staff overseeing non-student minors, who participate in any University programs. The University expects all members of the University community to adhere to and act in accordance with this policy. Failure to comply with the requirements set forth in thi The documentation guidelines are available in 1995 and 1997 versions, and we are allowed to use either one. Of note, the only significant difference between the two versions is the exam section Medicaid and Medicare's 1997 Documentation Guidelines for Evaluation and Management Services (Attachment B). PROCEDURE: Documentation within the health record should be: 1. Complete and legible. 2. Completed in a timely manner - documentation entries should be generated at the time of service or shortly thereafter 3

scientific evidence, to write the guidelines document and to facilitate discussion among the working group members in order to formulate the recommendations. A steering group consisting of the Programme Lead, project team members and the chairs of the four working groups, signed off on the content and recommendations in the guidelines document • Written ASC policies and procedures that address the circumstances warranting emergency transfer, including who makes the transfer decision; the documentation that must accompany the transferred patient; and the procedure for accomplishing the transfer safely and expeditiously, including communicating with the receiving hospital - Minor procedures: 0-10 global days • Patient presents to her PCP with chest pain. Physician documents a Detailed History, Detailed Exam and Moderate MDM. He orders an EKG, which is performed in the office. - Report 99214-25 and 93000. • -57 - Major Procedures: 1 day preoperative and 90 days postoperativ If, in addition to the procedure, the physician performs an E/M service that is beyond the usual pre-procedure, intra-procedure and post-procedure associated care, the E/M may be reported with modifier 25 appended. The E/M service must be appropriately documented and unrelated to the decision to perform the minor surgical procedure

MR documentation requirements include a complete review of the resident's notes by the teaching physician, as well as documentation of the extent of the teaching physician's review and if germane, his/her participation in the service including any follow up discussion with the resident, being careful to note any change(s) in data points or. Documentation Guidelines for Medicare Services Incomplete or illegible records can result in denial of payment for services billed to Medicare. In order for a claim for Medicare benefits to be valid, there must be sufficient documentation in the provider's or hospital's records to verify the services performed were reasonable and necessary. Guidelines based on a critical appraisal of the scientific evidence clarify which interventions are based on proven benefit and document the quality of the supporting data. They also alert clinicians to those interventions that are unsupported by good science, reinforce the importance and methods of critical appraisal, and call attention t Documentation of Assent and/or Parental Permission • Children Under 7 • Children 7 - 12 • Adolescents 13 - 17 Re-Assent and Consent at Youth and Adult Milestones. Waiver of Child Assent Waiver of Parental Permission. Legal Exceptions Permitting Certain Minors to Consent • Emancipated Minors • Self-Sufficient Minors • Minors 12. The New York State Surgical and Invasive Procedure Protocol (NYSSIPP) applies to all operative and invasive procedures including endoscopy, general surgery or interventional radiology. Other procedures that involve puncture or incision of the skin, or insertion of an instrument or foreign material into the body are within the scope of the protocol

2021 E&M Coding Guidelines . Created: 2020-12 Page 1 By B Fisher, B Hart, V Jain, T Mailisch for SMFM Coding Committee . Code Time. 1 (min) MDM (2 of 3 elements) Diagnosis. 2 (no. and complexity of problems addressed) Data. 3 (amount and complexity of data to review and analyze) Risk (complications and/or morbidity or mortality of patient. In January 2013, CMS released updated instructions to the National Correct Coding Initiative. In the Integumentary Section of these instructions, new guidelines and rules were provided on billing E/M visits (for both new and established patients) with minor procedures. A minor procedure is a code with 0 or 10 postop days Established Patient 99213 Documentation Requirements When reporting for telemedicine • Modifier -95 may be required depending on the payer • Place of service is 11, which also may vary by payer 99213 - Office or other outpatient visit for the evaluation and management of an established patient, which requires two of three of these components

Coding for minor surgical procedures Avoiding costly error

  1. istered to your patients. The requirements are defined in the National Childhood Vaccine Injury Act enacted in 1986. The law applies to all routinely recommended childhood vaccines, regardless of the age of the patient receiving the vaccines
  2. or surgery is not required with E/M code. Diagnosis for E/M service and other procedure may be same or different Use to indicate that an E/M service was provided on same day as another procedure that would normally bundle under National Correct Coding Initiative (NCCI)
  3. Obtaining Written or Verbal Informed Consent. Obtaining consent involves explaining the research and assessing participant comprehension using a consent document, usually a written consent form or information sheet, as a guide for the verbal explanation of the study. Informed consent from the participant and/or his or her legally-authorized representative (surrogate) must be obtained prior to.

FAQ: Scoring elements in the new E/M guidelines for 202

Beyond that, procedure notes have some unique requirements. Here is a list of elements commonly included in a procedure note: Type of procedure: For example, a simple laceration repair, diagnostic lumbar puncture, I&D of abscess. Who performed the procedure: Include both name and designation (e.g. MS3, CC4, PGY2) Time Out Documentation for Bedside and Clinic Procedures Practicing time out prior to a procedure is a nationally recognized patient safety measure, which helps assure that the correct procedure is performed on the correct patient • Emergency major surgery (open, percutaneous, or endoscopic) • Parenteral controlled substances • Drug therapy requiring intensive monitoring for toxicity • Decision not to resuscitate or to de-escalate care because of poor prognosis * Taken from the 1995 Documentation Guidelines for Evaluation and Management Services, available a

Minor Surgery and Endoscopies - JE Part B - Noridia

No supporting documentation is required with the claim when this modifier is submitted ; A different ICD-9-CM code from the one submitted with the minor surgery is not required with the E/M code. The diagnosis for the E/M service and the other procedure may be the same or different Often people have confusion about the differences between minor and major surgeries. Continue to learn about the pints of differentiation between both forms.Minor Surgery A minor surgery is any procedure that neither penetrates a body cavity, nor encourages permanent impairment of any bodily functions. Procedures like superficial vascular cut down, endoscopy, laparoscopy, implanting pumps in. surgery allowance for the procedure code when all of the following criteria are met: • The surgical procedure code is a major surgery (global period of 090 days). • Modifier -57 is appended to the E/M code. • The medical record documentation supports the use of modifier 57 Additional Documents for Special Circumstances. Minor Has Only One Parent/Guardian. Evidence of sole authority to apply for the minor must be submitted with the application in the form of a: U.S. or foreign birth certificate, Consular Report of Birth Abroad, or adoption decree, listing only the applying paren Permanent Resident Card with notation, Signature Waived: Additionally, a Permanent Resident Card with a USCIS-issued sticker extending its validity is a List A document and acceptable for Form I-9. Form I-766, Employment Authorization Document Card. USCIS began issuing the current card on May 1, 2017

The table only indicates the minimum requirements for the background check process for sponsors and others. ORR may require additional checks, verifications, or procedures for sponsors and others in any category if there are any unresolved issues or questions related to the well-being of the child Check-in and required documents. Arrive at least 2 hours before the scheduled departure time of your child's flight and speak with a ticket counter agent. Children traveling alone can't check in online or at the kiosk. You'll need to fill out an unaccompanied minor form and any necessary Customs and Immigration documents for the day of. Applicants are required to furnish original documents along with one set of self-attested photocopies of the same at the Passport Seva Kendra (PSK) for processing. Minor. It is assumed that consent of both parents is available, unless specified. For minor applicants, present address proof document in the name of parent (s) can be submitted

The Directorate of Technical Support and Emergency Management presents the 29 CFR 1910.147, Lockout/Tagout Interactive Training Program.We developed the program jointly with the Directorates of Enforcement Programs, Safety Standards and Guidance, the Office of Training and Education, and the Office of the Solicitor Surgical and Invasive Procedure Protocol September 2006 Page 4 In 2000, the NYSDOH impaneled experts to develop guidelines to reduce wrong patient, wrong site, wrong side and wrong invasive procedures. The recommendations of that panel, The Pre-Operative Protocols for Hospitals, Ambulatory Surgery Centers, and Individua Personal documents - You'll need to bring all of the following: An original proof of citizenship document. An acceptable photo ID document. A photocopy of the front and back of the citizenship document and photo ID document. Passport photo - Follow the photo requirements. Payment - Calculate your passport fees. How to Renew a U.S. Passpor Minors Who Are Not Children:In California certain people under 18 years of age are legally able to consent for treatments or procedures involved in research. In the terms used in these guidelines, they are minors but not children. For example, California Family Code 6925 says, A minor may consent to medica

Clinical Documentation Standards . This policy section defines the procedures and minimum standards for documentation of Medicare/Medi-Cal Specialty Mental Health Services at any site providing those services within Alameda County Behavioral Health Care Services and its Behavioral Health Plan's Provider Network •Documentation Guidelines -CMS 1995 -CMS 1997 •May choose guidelines that are most favorable to the provider -Most will use 1995 Documentation Guidelines . Minor surgery w/ identified risk factors Moderate 99283 99284 1 or more chronic illnesses w/sever

1.2 General Overview of Procedures Prior to the ophthalmology testing, the SP will complete the NHANES Vision examination component which includes visual acuity and objective refraction for SPs aged 8 years and older i Guidelines outlining the minimum requirements for patient information that should be collected, and, activities that should be completed prior to and after a colonoscopy procedure Three sample checklists including a Day-of Procedure Pre-Procedural Checklist, Procedure Room Pre-Procedura The bank's procedures must describe when it uses documents, non-documentary methods, or a combination of both methods to verify the identity of its customers. 23. Verification Through Documents . A bank relying on documents to verify a customer's identity must have procedures that set forth the documents that the bank will use. 2 Development Department, in accordance with the requirements in §16.24.100-§16.24.140. This shall only be required if the Community Development Department has asked for additional documentation at the time of the preapplication meeting. 12/22/2017 $ $ $ $ MINOR SUBDIVISION APPLICATION (c o n t ' d

It's possible for example to devise a revision scheme where substantive changes are whole numbers (revisions 1, 2, 3, etc.) and minor editorial updates have a concomitant minor designation such as 2.1 or B1. In such cases the document control requirements can be written such that a minor change doesn't have to go through the full approval. Learning Objectives 1. Identify key definitions related to documents and records 2. Describe key categories and how they inter -relate 3. Describe requirements and intent for Document Controls Children Under 16. All children under age 16 must apply for a passport in person with two parents or guardians using Form DS-11. You cannot renew your child's passport. Passports for children under age 16 are only valid for 5 years. ALL / requirements for deviation documentation and reporting to the sponsor. Study- • Conducting study procedures at an unapproved site • Minor deviations that may not individually require reporting, but that are continually repeated without correction or implementation of

treatment/procedure(s). 2.2 Minor Patient's Legal Representative: a) If the minor patient is not considered to be a mature minor, their legal representative may provide informed consent or refuse to provide informed consent to the treatment/procedure(s) for the minor patient. This is most often their legally identified parent or guardian General Guidelines for claims submitted to Carriers or Intermediaries or Part A or Part B MAC: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare A Document Revision Control system is the spine of your Quality Assurance Program. It is critical for ISO 9001 implementation. This system documents the methods that your organization uses to control, review and approve its documentation. Your easy to edit ISO 9001:2015 Quality Assurance Manual Documentation required to travel to foreign countries and/or re-enter the United States varies by country. Visit our portal and enter your origin/destination for documentation requirements specific to your itinerary. A valid passport is always required for international travel, in addition to other documentation based on your destination According to the 1997 E/M documentation guidelines, a single organ system examination or a general multi-system examination may be performed by any physician regardless of specialty; however, the documentation requirements differ between the two examination types. • Minor surgery with no identified risk factor

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Flight procedures for accompanied and unaccompanied minors vary with each airline and whether a flight is domestic or international, nonstop or connecting. The TSA has standardized rules Outpatients Department for Minor Surgery Version 1 (March 2017) Page 1 of 10 CONTENTS 1. Introduction 2. Minimum requirements 3. Learning outcomes 4. Preparation of room and resources 5. Preparation of patient prior to surgery 6. Care of patient during minor surgery 7. Documentation 8. Disposal and processing of used equipment 9. Competency. If the patient is a minor, the provider should retain health information until the patient reaches the age of majority (as defined by state law) plus the period of the statute of limitations. A longer retention period is prudent, since the statute may not begin until the potential plaintiff learns of the causal relationship between an injury. SUBMITTAL REQUIREMENTS AND PROCEDURE Sec. 17-64 of Johnstown Municipal Code (JMC) Pre-Application Information Applicants are responsible for being familiar with the submittal checklist, and all design guidelines, municipal code, standards and specs, and any development or annexation agreements that may apply to the subject property. Proces

Know When to Bill E/M with a Minor Procedure - AAPC

Step 6: Implement Reasonable Procedures to Protect the Security of Kids' Personal Information. Chart: Limited Exceptions to COPPA's Verifiable Parental Consent Requirement Step 1: Determine if Your Company is a Website or Online Service that Collects Personal Information from Kids Under 13 Minor weaknesses, deficiencies, and technical violations alone are not indicative of an inadequate CIP. Identity Verification Procedures. The CIP must include risk-based procedures for verifying the identity of each customer to the extent reasonable and practicable. 5 31 CFR 1020.220(a)(2)

Minor Surgical Procedures - How to document and bill

procedure or treatment involved. Minor procedures — such as the removal of a minor skin lesion or the filling of caries — may require only a simple discussion of ris ks. However, as procedures become more complex or have a greater degree of risk, the consent process should be more comprehensive Billing Guidelines and Documentation Requirements for CPT® Code 99211 25. Genetic Counseling Services Billing Guidelines 26. Lactation Consultant Services Billing Guidelines Outpatient Surgery 2. Minor Surgery 3. Acute Care Fee Schedules 4. Acute Care Emergency Room Services 5. IV Therapy Service Recap of Coding Clinic, First Quarter 2014 . By Sharme Brodie, RN, CCDS . In the first quarter of 2014 the AHA published the inaugural issue of a stand-alone Coding Clinic for ICD-10-CM and ICD-10-PCS.Coding Clinic also issued a farewell issue of Coding Clinic for ICD-9-CM at the same time. This was a very dense, full edition so without further ado, let's take a look at what was inside The documentation guidelines explicitly state that the physician should use the high- • Minor surgery with identified risk factors; • Elective major surgery (open

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Thinking on Paper: Documenting Decision Making -- FP

TSA does not require children under 18 to provide identification when traveling within the United States. Contact the airline for questions regarding specific ID requirements for travelers under 18. Forgot Your ID? In the event you arrive at the airport without valid identification, because it is lost or at home, you may still be allowed to fly Clarify Requirements 09/03/08 C R.G. Revised to replace AEW & EW call outs with ISER Consolidate into an ISER document 07/21/09 D R.G. Revised to update IWO requirements and ISER to AS Clarify Requirements 08/02/12 E R.G. Revised to clarify BAMS and MRB membership requirements Remove d MLB - Clarify Requirements CPT modifier 25: The E/M service, performed on the same day as a minor surgery (000 or 010 global days) is significant and separately identifiable from the usual work associated with the surgery. Documentation in the patient's medical record must support the use of this modifier All children, including infants, must have their own passport or Trusted Traveler Program document for U.S. entry. Carry documents for traveling with minor children. If you are escorting a minor child without the parents, have a letter from both parents indicating that you have permission to travel with the minor Medicare Surgery Guidelines • Major procedures: - Preoperative visits beginning with the day before the day of surgery. - Intraoperative services that are normally a usual and necessary part of a surgical procedure. - All additional medical or surgical services required of the physician within 90 days of the surgery because of complication

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Ophthalmic Professional - Document minor surger

Oklahoma State University Policy and Procedures . REQUIREMENTS FOR UNDERGRADUATE AND GRADUATE MINORS 2-0128 ACADEMIC AFFAIRS February 2015. PURPOSE AND SCOPE . 1.01 Minors provide a means by which a matriculated student may record significant educational experience in coursework either outside, or ancillary to, the requirements for th The following guidelines apply to worldwide travel on Delta and Delta Connection carriers. Travel Agents may make reservations for Unaccompanied Minor (UMNR) travel and contact Global Sales Support, Delta Reservations or the dedicated UMNR phone number 800-325-8847, for assistance with required documentation minor surgery Minor procedure Surgery Any surgical procedure that can be performed in a brief period of time-usually < 1 hr under local anesthesia, does not-under normal circumstances—constitute a major hazard to life or function of organs or body parts; MS does not generally require hospitalization and may be performed electively, usually by a general-board-certified surgeon in a.

documents (i.e., most recent 1040 form, divorce decree, etc.) submitted with the application. The application procedure must include an interview with all adult household members to review the application and historical documents and clarify any discrepancies or missing information. (For example, if the recent 1040 form and W-2s show tw Risks for any surgery includes bleeding, infection, damage to surrounding organs, stroke, heart attack and death. The latter three are less likely with minor surgeries without gen anesthesia and therefore my thinking is surgeries with a global period of ten days (ie skin excisions) are minor whereas surgeries with globals of 90 days are considered major recording all documents necessary to complete the boundary line adjustment. Minor Boundary Line Adjustment Legal Description & Exhibit Requirements . The following information must be included with the Minor Boundary Line Adjustment application. Information must be prepared by a licensed Land Surveyor in accordance with the following minor, marriage certificate, military identification card, birth certificate and minor's written affirmation of meeting the state law's criteria for living independently) the anesthesia professional should inquire as to whether the appropriate review and verification has taken place by the facility and document the result of the inquiry i Procedure codes with a CMS assistant surgeon indicator of 1 or 9 are not eligible for assistant surgeon reimbursement. CMS guidelines indicate assistant surgeons cannot be paid on these procedures. No criteria or guidelines for approval upon appeal have been established for procedure codes with an indicator of 1 or 9

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