MFS Reference Tool FAQs
Table of Contents
Why Did the Tool Show a Successful Result but the Data Showed N/A?....................................... 4 Why Did the Tool Show ‘Not Found’ When I Entered a Valid CMG Code such as a0201? ............ 6 Why Did the Tool Show ‘Not Found’ When I Entered a Valid CPT Code for an Injectable Drug? The Code is Listed in OP % Charges. ............................................................................................... 8 Why Do I Get the Message, ‘Not Found’ When Adding a Modifier to Certain Codes?................ 10 This table lists each medical fee schedule and where it can be found in the look-up tool ......... 12 Out of State Providers................................................................................................................... 14
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Tool Category Service Type – Secondary Service Type (from look-up tool)
MFS Tab Category (from Fee Schedule)
Code types for entry
IP Acute
Hospital (Inpatient) – Acute
MS-DRG
IP Rehab
Hospital (Inpatient) – Rehab
CMG
Revenue, Revenue+CPT, Revenue+HCPCS, HCPCS J-CODE
OP % Charges
Hospital (Outpatient)
OP CPT
Hospital (Outpatient)
CPT (Modifier if applicable)
OP HCPCS
Hospital (Outpatient)
HCPCS (Modifier if applicable)
ASC % Charges
Ambulatory Surgical Center
Revenue Code
ASC Surgeries
Ambulatory Surgical Center
CPT
ASC Fluoroscopy
Ambulatory Surgical Center
CPT (Modifier if applicable)
Prof and Other Prov % Charges
Professional Services – Injectable drugs
CPT, HCPCS, HCPCS J-Code
Prof Anesthesia
Professional Services – Anesthesia
CPT, (Modifier if applicable)
Prof Surgery
Professional Services – All Other Services
CPT, Has Modifiers
Prof Radiology
Professional Services – All Other Services
CPT, Has Modifiers
Prof LabPath
Professional Services – All Other Services
CPT (Modifier if applicable)
Prof E&M
Professional Services – All Other Services
CPT
Prof Other Medicine
Professional Services – All Other Services
CPT (Modifier if applicable)
Prof HCPCS – 1
Professional Services – All Other Services
HCPCS (Modifier if applicable)
Prof HCPCS – 2
Professional Services – All Other Services
HCPCS (Modifier if applicable)
Prof HCPCS – 3
Professional Services – All Other Services
HCPCS
Prof HCPCS – 4
Professional Services – All Other Services
HCPCS
Prof HCPCS – 5
Professional Services – All Other Services
HCPCS (Modifier if applicable)
Phys Med and Rehab Physical Medicine and Rehabilitation Services
CPT, HCPCS
Osteopathic and Chiropractic Manipulative Treatment
OsteoChiro
CPT
Acupuncture
Acupuncture
CPT
Dental
Dental
HCPCS
Ambulance
Ambulance
HCPCS
S Codes
S Codes
HCPCS
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