45 CFR 162.1002 - Medical data code sets

Cite as45 CFR 162.1002
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74 practice notes
  • Human drugs, biological products, and animal drugs; foreign and domestic establishment registration and listing requirements,
    • United States
    • Federal Register August 29, 2006
    • August 29, 2006
    ...drugs is the NDC (see final rule on ``Health Insurance Reform: Standards for Electronic Transactions'' (65 FR 50312, August 17, 2000), 45 CFR 162.1002(c); amended February 20, 2003: ``Health Insurance Reform: Modifications to Electronic Data Transaction Standards and Code Sets'' (68 FR 8381......
  • Part II
    • United States
    • Federal Register August 29, 2006
    • August 29, 2006
    ...drugs is the NDC (see final rule on ``Health Insurance Reform: Standards for Electronic Transactions'' (65 FR 50312, August 17, 2000), 45 CFR 162.1002(c); amended February 20, 2003: ``Health Insurance Reform: Modifications to Electronic Data Transaction Standards and Code Sets'' (68 FR 8381......
  • Almy v. Sebelius, Civil Action No. RDB–08–1245.
    • United States
    • United States District Courts. 1st Circuit. United States District Courts. 1st Circuit. District of Massachusetts
    • September 3, 2010
    ...an electronic DME claim must include a Healthcare Common Procedure Coding System (“HCPCS”) billing code. 45 C.F.R. §§ 162.1000(a), 162.1002(b)(3). Medicare benefit claims are processed by administrative contractors, which are private insurance companies hired by the Secretary to perform var......
  • United States v. Marder, Case No. 1:13-cv-24503-KMM
    • United States
    • United States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
    • September 23, 2016
    ...services," id. § 1395w–4(c)(5). The Secretary of HHS acted on this authority by adopting the CPT code set drafted by the AMA. 45 C.F.R. § 162.1002 ; see also United States v. Semrau, 693 F.3d 510, 530 (6th Cir.2012).9 "Incident to services" are services that are furnished by other employees......
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11 cases
  • Almy v. Sebelius, Civil Action No. RDB–08–1245.
    • United States
    • United States District Courts. 1st Circuit. United States District Courts. 1st Circuit. District of Massachusetts
    • September 3, 2010
    ...an electronic DME claim must include a Healthcare Common Procedure Coding System (“HCPCS”) billing code. 45 C.F.R. §§ 162.1000(a), 162.1002(b)(3). Medicare benefit claims are processed by administrative contractors, which are private insurance companies hired by the Secretary to perform var......
  • United States v. Marder, Case No. 1:13-cv-24503-KMM
    • United States
    • United States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
    • September 23, 2016
    ...services," id. § 1395w–4(c)(5). The Secretary of HHS acted on this authority by adopting the CPT code set drafted by the AMA. 45 C.F.R. § 162.1002 ; see also United States v. Semrau, 693 F.3d 510, 530 (6th Cir.2012).9 "Incident to services" are services that are furnished by other employees......
  • United States ex rel. Eastlick v. Odom, C/A No. 3:20-cv-00803-CMC
    • United States
    • United States District Courts. 4th Circuit. United States District Court of South Carolina
    • October 28, 2021
    ...became a valid billing code-set by which healthcare providers may bill the federal government for reimbursement under Medicare. See 45 C.F.R. § 162.1002(a)(5), (c) (providing CPT Codes developed and maintained by the American Medical Association are a valid code-set by which healthcare prov......
  • United States ex rel. Montcrieff v. Peripheral Vascular Assocs., P.A., SA-17-CV-00317-XR
    • United States
    • United States District Courts. 5th Circuit. Western District of Texas
    • December 14, 2020
    ...(CPT–4), as maintained and distributed by the American Medical Association, for physician services and other health care services. 45 C.F.R. § 162.1002(a)(5). The CPT-4 continues to be a valid method of billing medical services to Medicare for reimbursement. Id. § 162.1002(c).PVA and other ......
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