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HomeMy WebLinkAbout20240428.tiffRESOLUTION RE: APPROVE AMENDMENT #6 TO DIAGNOSTIC SERVICES AGREEMENT FOR WOMEN'S WELLNESS CONNECTION PROGRAM AND AUTHORIZE CHAIR TO SIGN - BANNER IMAGING SERVICES COLORADO, LLC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with Amendment #6 to the Diagnostic Services Agreement for the Women's Wellness Connection Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and Banner Imaging Services Colorado, LLC, commencing July 21, 2024, and ending July 20, 2027, with further terms and conditions being as stated in said amendment, and WHEREAS, after review, the Board deems it advisable to approve said amendment, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that Amendment #6 to the Diagnostic Services Agreement for the Women's Wellness Connection Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and Banner Imaging Services Colorado, LLC, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said amendment. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 21st day of February, A.D., 2024. BOARD OF COUNTY COMMISSIONERS WELD COU O ATTEST: _.)�� Weld County Clerk to the Board . I,c %61 - APP Deputy Clerk to the Board FORM: ounty Attorney IDate of signature: z'7 / Z - Ross, Chair Perry L. ck, Pro-Tem EXCUSED Mike Freeman ScottK. James ne CC: H'L 0c/5M f6F) O g/og/, q 2024-0428 HL0057 Corrivac+ �D���B► BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Banner Imaging Services 6'" Amendment for WWC Diagnostic Imaging/Radiology DEPARTMENT: PUBLIC HEALTH AND ENVIRONEMNT DATE: January 19, 2024 PERSON REQUESTING: Jason Chessher, Executive Director Shaun May, Public Health Services Director Brief description of the problem/issue: For the Board's review and approval is a contract renewal between Banner Imaging Services Colorado, LLC and the Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment (WCDPHE). The Health Department requests approval of this 6'h amendment of our contract with Banner Imaging Services Colorado, LLC to provide the diagnostic imaging/radiology services (mammograms, ultrasounds, and MRIs) to eligible Women's Wellness Connection (WWC) patients referred to Banner Imaging Services by the Health Department. This 6'h amendment will extend this agreement till July 20, 2027. Activities will be conducted by current staff; no additional FTE is being requested. What options exist for the Board? Consequences: If the Board declines to approve this agreement, the WCDPHE will not be able to provide optimal care for our patients. This will result in greater challenges for us to assist qualified patients at increased risk of breast and cervical cancer in connecting with diagnostic and radiology services. Impacts: With approval of the Board, the WCDPHE will be able to connect our qualified WWC patients with Banner Imaging resulting in improved health outcomes and increased customer service. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): This is a no -cost agreement with Banner Imaging. The cost of the services provided by Banner Imaging will be invoiced and paid by WCDPHE. The Colorado Department of Public Health and Environment (CDPHE) Women's Wellness Connection program will reimburse the WCDPHE. A list of the surgical services to be provided and their associated cost is listed in Appendix A. Recommendation: I recommend approval of this agreement with Banner Imaging for WWC patients. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross , Chair Lori Saine #4 2/Z I 2024-0428 01,0031 Cheryl Hoffman From: Sent: To: Cc: Subject: Approve - thanks! Scott James Monday, January 22, 2024 8:45 AM Cheryl Hoffman Esther Gesick Re: Banner Imaging WWC Scott K. James Weld County Commissioner, District 2 1150 O Street, P.O. Box 758, Greeley, Colorado 80632 970.336.7204 (Office) 970.381.7496 (Cell) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. On Jan 22, 2024, at 8:35 AM, Cheryl Hoffman <choffman@weld.gov> wrote: Here's the 3rd of 7. Do you approve of placement on the BOCC agenda after your review? Cheryl L. Hoffman Deputy Clerk to the Board 1 150 O Street/P.O. Box 758 Greeley, CO 80632 Tel: (970) 400.4227 choffman@weld.gov From: Karla Ford <kford@weld.gov> Sent: Sunday, January 21, 2024 1:35 PM To: Cheryl Hoffman <choffman@tweld.gov> Subject: FW: Banner Imaging WWC Karla Ford X SIXTH AMENDMENT TO DIAGNOSTIC SERVICES AGREEMENT (FOR WOMEN'S WELLNESS CONNECTION PROGRAM) (031403.43839) THIS SIXTH AMENDMENT TO DIAGNOSTIC SERVICES AGREEMENT (FOR WOMEN'S WELLNESS CONNECTION PROORAM) (this "Amendment") is made and entered into as of the signature dates set forth below, to be effective as of July 21, 2024, by and between BANNER IMAGING SERVICES COLORADO, LLC, a Colorado limited liability company ("BIS"), and County of Weld, State of Colorado, by and through the Board of Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment ("WCDPHE"), WIT NESSETH: WHEREAS, WCDPHE and Banner Health, an Arizona nonprofit corporation d/b/a North Colorado Medical Center ("Banner") are parties to that certain Services Agreement dated July 21, 2014, as amended (together the "Agreement"), pursuant to which Banner will provide the technical component of the diagnostic imaging/radiology services (the "Services") as more particularly described therein; and WHEREAS, Banner wishes to assign all of its right, title and interest under the Agreement to BIS; and WHEREAS, BIS is a subsidiary of and solely owned by Banner; and WHEREAS, in accordance with the terms and conditions hereof, the parties desire to amend the Agreement to memorialize the assignment of the Agreement and clarify certain provisions to state that BIS will provide both the professional and technical component ofthe Services as set forth in the Agreement among other things. NOW, THEREFORE, for and in consideration of the mutual covenants and promises contained herein, the receipt and sufficiency of which am hereby acknowledged, it is understood and agreed upon by the parties hereto as follows: I. Amendment of Agreement A. Paragraphs 3,4,5,6 and 7 of the Recitals are hereby deleted and replaced as follows: WHEREAS, BIS operates certain outpatient clinics providing radiology services (the Clinics"); and WHEREAS, MS provides the technical and professional component of diagnostic imaging/radiology services (the "Services") at the Clinics; and WHEREAS, WCDPHE desires to engage BIS to provide the technical and professional components of the diagnostic imaging/radiology services for the Designated Patient(s) of the Program and BIS desires to be so engaged, in accordance with the terms and conditions set forth herein. Section 1.1 of the Agreement is hereby deleted in its entirety and replaced as follows: 1.1 Provision of Services. Cpon presentation of a voucher as set forth on (Schedule B) attached hereto and incorporated herein by this reference, and if required, an order of an appropriately licensed provider (employed or otherwise contracted to provide services to WCDPHE), BIS shall provide the technical and professional component of such diagnostic imaging/radiology services (the "Services") to the Designated Patient(s) as set forth on ("Schedule A"), at the Medicare Rates and CPT Codes for the Women's Wellness Connection, attached hereto and incorporated herein by this reference. BIS shall supply all qualified personnel, materials, and equipment necessary to provide the Services. C. Section 1.2 ofthe Agreement is hereby deleted in its entirety and replaced as follows: 1.2 Results. BIS shall prepare or cause to be prepared written or electronic reports in medical terminology with respect to all Services. BIS shall, upon request by a treating provider at WCDPHE., provide test results and formal recommendations to WCDPHE within seven (7) days after test completion. Otherwise, Banner shall provide WCDPHE with that amount of information concerning the program participant ass necessary for WCDPHE to make payment for the Services provided. D. Section 3 (Term and Termination) of the Agreement is hereby amended to extend the term of the Agreement for an additional three (3) year period as of the Effective Date and continuing through July 20, 2027, subject to earlier termination as provided in Section 3 of the Agreement. E. Section 4.1 of the Agreement is hereby deleted in its entirety and replaced as follows: 4.1 Compensation. WCDPHE agrees to compensate BIS for the Technical Services at the rate of one hundred percent (l00%) of the allowable payment for each type of diagnostic/imaging radiology service provided to a Designated Patients, based upon Schedule A Medicare Rates and CPT Codes for the Women's Wellness Connection, in effect at the time the Services are performed. 4.1.1 FundsAvailability. Financial obligations of WCDPHE payable afterthe current fiscal year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. Execution of this Agreement by WCDPHE does not create an obligation on the part of WCDPNE to expend funds not otherwise appropriated in each succeeding year. F. Section 4.2 null's Agreement is hereby deleted in its entirety and replaced as follows: 4.2 (j in . BIS shall submit invoices monthly to WCDPHE for Services provided to Designated Patient(s). WCDPHE shall pay such invoices within thirty (30) days following the month in which the Services were rendered. BIS agrees that BIS shall not, under any circumstances, bill any Designated Patient(s) or third -party payer for the Services provided pursuant to this Agreement. Section 6 of the Agreement is hereby deleted in its entirety and replaced as follows: 6. Mutual Indemnification. As permitted under Colorado law, each party shall indemnify and save harmless the other party for, from and against all actions, liabilities, losses, damages, claims and demands whatsoever, including costs, expenses and attorneys' fees, resulting, or claimed to have resulted solely from any intentional or negligent acts or omissions of the indemnifying party or its employees, subcontractors or agents engaged in the work under this Agreement at the time of the event or occurrence upon which such actions, claims or demands are based. G. Section 19 o f the Agreement shall be updated so that notices will be provided to BIS and Banner Health at the following address: Banner Imaging Services Colorado, LLC 2901 N. Central Ave., Suite 160 Phoenix, AZ 85012 Attn: BIS CEO With a copy to: Banner Health 2901 N. Central Ave., Suite 160 Phoenix, AZ 85012 Attn: General Counsel 2. Assieoment. BIS hereby accepts the forgoing assignment and assumes all obligations ofthe Banner under the Agreement arising from and after the Effective Date. All of the terms covenants and conditions set forth herein shall be binding upon Banner and its successors and assigns and inure to the benefit of the BIS and its successors and assigns. 3. Accentance of Assienment Banner joins in this Amendment to consent to this assignment form and after the Effective Date. 4. Agreement Effective. Except as otherwise expressly provided herein, MI terms and conditions of the Agreement shall remain unmodified and in full force and effect, including previously executed amendments to the original agreement. 5. Precedence of Amendment. In the event of a conflict between the terms and conditions of this Amendment and the terms and conditions of the Agreement, the terms and conditions ofthis Amendment shall govern and control. 6. Capitalized Terms. All capitalized terms used in this Amendment and not otherwise defined herein shall have the meaning ascribed to such terms in the Agreement. 7. Incorporation. This Amendment shall be attached to, and made a part of, the Agreement. 8. Counterparts. This Amendment may be executed in one or more copies or counterparts, each of which when signed shall be an original, but all of which together shall constitute one instrument. [Signature Page to Follow.) DocuSign Envelope ID: 074CE887-8F84-4A72-A4F8-2DBB66BFCA6C IN WITNESS WHEREOF, the parties hereto have executed this Amendment, or by signature oftheirduy authorized representative, as ofthe signature dates set forth below, to be effective as ofthe Effective Date. BANNER IMAGING SERVICES COLORADO, LLC: Name: 'i'° Title: VP Ambulatory Services Date: April 22, 2024 I 8:26 PM MST ATTEST: BY: DATE: ASSIGNMENT ACCEPTED AND AGREED TO: BANNER HEALTH Name: ,�tiM lot` Title: VP Ambulatory Services Date: April 22, 2024 I 8:26 PM MST 4 BOARD OF COUNTY COMMISSIONERS WELD COUNTY OLOFtADO Bela D. Ross, Chair FED 2 2024 ooa 1 a4ia8` Schedule A Medicare Rates and CPT Codes - Updated June 2023 (updates in Bold) Cancer Prevention and Early Detecton Program/Women's Wellness Connection Clinical Services Reimbursable Services and Procedures for June 30, 2023 to June 29, 2024 Listed below are allowable Connection (WWC) https://www.cros.gov/medicare/physician-fee-schedule/search/overview. procedures Clinical Services and the corresponding program. These rates are CPT codes based on information for use in the Rates are incorporated covered related to contact through Cancer found on WWC cancer screening your CDPHE Prevention the Centers into the Clinical Organizational and for program's Services and diagnostics Early Medicare Bundled Detection and of Lead and to the for Payment Medicaid aid breast approval (CPED)/Women's Wellness website, System (BPS) at in negotiating subcontracts. and cervix may be of any codes not the eligible on this beginning of Reimbursement for reimbursement list. each fiscal for through year. Codes treatment services the CPED/W are is provided not allowed. WC Clinical to show what Additional Services services are CPT codes program. Please CPT CODES OFFICE VISITS End Notes 2023 CO Rates 2023 Prof (2 6) 2023 Tech (TC) 99202 New patient; expanded history, exam, straightforward decision -making; 15-29 minutes $74.40 99203 New Patient; detailed history, exam, straightforward decision -making; 30-44 minutes $114.59 99204 New Patient; comprehensive history, exam, moderate complexity decision -making; 45-59 minutes I $169.84 99205 New patient; comprehensive history, exam, high complexity decision -making; 60-74 minutes 1 $224.00 99211 Established patient; evaluation and management, may not require presence of physician; presenting problems are minimal $24.19 99212 Established patient; history. exam, straightforward decision -making; 10-19 minutes $58.20 99213 Established Patient; expanded history, exam, straightforward decision -making; 20-29 minutes $92.52 99214 Established Patient; detailed history, exam, moderately complex decision -making; 30-39 minutes $130.73 99385 Initial comprehensive preventive medicine evaluation and management; history, examination, counseling and guidance, risk factor reduction, ordering of appropriate immunizations and procedures; 18 to 39 years of age lab 2 intentionally left blank 99386 Same as 99385, but 40 to 64 years of age 2 intentionally left blank 99387 Same as 99385, but 65 years of age or older 2 intentionally left blank 99395 Periodic counseling procedures; comprehensive preventive and guidance, risk 18 to 39 years of medicine evaluation and management; history, examination, factor reduction, ordering of appropriate immunizations and lab age 2 intentionally left blank 99396 Same as 99395 but 40 to 64 years of age 2 left intentionally blank 99397 Same as 99395, but 65 years of age or older 2 intentionally left blank CPT CODES BREAST SCREENING AND DIAGNOSTIC SERVICES \otes End 2023 (1) Rates 2023 Prof (26) 2023 Tech (TC) 76098 Radiological examination, surgical specimen 544 A lo $15.37 $28.74 76641 Ultrasound, complete examination of breast including axilla, unilateral $109.12 $35.55 $73.57 76642 Ultrasound, limited examination of breast including axilla, unilateral 3 $89 62 $33 13 $56 49 76942 Ultrasonic guidance for needle placement, imaging supervision and interpretation 3 $60 46 $30 66 $29 80 19000 Puncture aspiration of cyst of breast $106 66 19001 Puncture aspiration of cyst of breast, each additional cyst, used with 19000 $26 77 ., 19100 Breast biopsy, percutaneous, needle core, not using imaging guidance $157 03 '' - _ ! --' `,: 19101 Excision Procedures on the Breast $341 80 19120 Excision of cyst, fibroadenoma or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion, open, one or more lesions $534 05 ` 19125 Excision of breast lesion identified by preoperative placement of radiological marker, open, single lesion $587 57 , ' 19126 Excision of breast lesion identified by preoperative placement of radiological marker, open, each additional lesion separately identified by a preoperative radiological marker $158 37 ; ri 4` = 'ri" " e , 19081 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, stereotactic guidance, first lesion 7 $532 20 , r ,, {„ i `{ ; A_ 19082 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, stereotactic guidance, each additional lesion 7 $414 74 _ „ 19083 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, ultrasound guidance, first lesion 7 $532 74 19084 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, ultrasound guidance, each additional lesion 7 $408 93 19085 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, magnetic resonance guidance, first lesion 7 $821 20 - - 19086 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, magnetic resonance guidance, each additional lesion 7 $640 86 - `' 19281 Placement of breast localization device, percutaneous, mammographic guidance, first lesion 8 $253 73 19282 Placement of breast localization device, percutaneous, mammographic guidance, each additional lesion 8 $181 22 ' '" _ - 19283 Placement of breast localization device, percutaneous, stereotactic guidance, first lesion 8 $274 20 1 ` ".^„;' „Y ,, 19284 Placement of breast localization device, percutaneous, stereotactic guidance, each additional lesion 8 $203 19 «' 19285 Placement of breast localization device, percutaneous, ultrasound guidance, first lesion 8 $395 45 ; 19286 Placement of breast localization device, percutaneous, ultrasound guidance, each additional lesion 8 $325 91 r ,_` 19287 Placement of breast localization device, percutaneous, magnetic resonance guidance, first lesion 8 $683 08 rs , `t 19288 Placement of breast localization device, percutaneous, magnetic resonance guidance, each additional lesion 8 $530 47 ^^ {"i ,'," 10021 Fine needle aspiration without imaging guidance, first lesion $105 75 10004 Fme needle aspiration biopsy without imaging guidance, each additional lesion $51 92 ' ,, 10005 Fme needle aspiration biopsy including ultrasound guidance, first lesion $141 13 10006 Fine needle aspiration biopsy mcludmg ultrasound guidance, each additional lesion $61 31 _ ` , w ' Yr 10007 Fme needle aspiration biopsy including fluoroscopic guidance, first lesion $312 29 - -.:'S,.', y` 10008 Fme needle aspiration biopsy mcludmg fluoroscopic guidance, each additional lesion $150 10 ,„: 10009 Fine needle aspiration biopsy mcludmg CT guidance, first lesion $459 72 10010 Fine needle aspiration biopsy including CT guidance, each additional lesion $250 62 4 t y y i�, 10011 Fine needle aspiration biopsy mcludmg MRI guidance, first lesion 9 (see end note) , 10012 Fme needle aspiration biopsy including MRI guidance, each additional lesion 9 (see end note) v. N 88172 Cytopathology, evaluation of tine needle aspirate, immediate cytohistologic study to determine adequacy of specimen(s), first evaluation episode $57 49 $35 51 $21 98 88177 Cytopathology, evaluation of fine needle aspirate, immediate cytohtstologtc study to determine adequacy of specimen(s), each separate additional evaluation episode $30 23 $21 69 $8 54 88173 Cytopathology, evaluation of fine needle aspirate, interpretation and report $168 51 $69 94 $98 57 88305 Surgical pathology, gross and microscopic examination $74 12 $37 20 $36 92 88307 Surgical pathology, gross and microscopic examination, requiring microscopic evaluation of surgical margins $304 31 $82 27 $222 04 400 Anesthesia for procedures on the integumentary system, antenor trunk, not otherwise specified Medicare Base Units = 3 14 (see end note) - ,�Y %'` - ` ' - A' 77053 Mammary ductogram or galactogram, single duct $56 12 $17 43 $38 70 77046 Magnetic resonance imaging (MRI), breast, without contrast, unilateral REQUIRES WWC PREAPPROVAL 6 $232 92 $69 78 $163 15 77047 Magnetic resonance imaging (MRI), breast, without contrast, bilateral REQUIRES WWC PREAPPROVAL 6 $241 15 $77 29 $163 86 77048 Magnetic resonance imaging (MRI), breast, mcludmg CAD, with and without contrast, unilateral REQUIRES WWC PREAPPROVAL 6 $370 54 $101 53 $269 01 77049 Magnetic resonance imaging (MRI), breast, mcludmg CAD, with and without contrast, bilateral REQUIRES WWC PREAPPROVAL 6 $377 98 $111 10 $266 88 77063 Screening digital breast tomosynthests, bilateral (3D mammography) 4 $54 96 $29 34 $25 62 77065 Diagnostic Mammography, unilateral, includes CAD $132 12 $38 99 $93 14 77066 Diagnostic Mammography, bilateral, includes CAD $166 70 $47 95 $118 76 77067 Screening Mammography, bilateral $135 40 $36 93 $98 48 G0279 Diagnostic digital breast tomosynthests, unilateral or bilateral (diagnostic 3D mammography) 5 $54 96 $29 34 $25 62 Various To include any pre -operative testing procedures medically necessary for the planned surgical procedure (e g , complete blood count, urinalysis, pregnancy test, pre -operative CXR, etc ) rM ,, '- ` ' ���- � �� t� b 4 �' tl , „t fk' '�' � J4 i�r ��sr �C � Srk;'''..1 kYel�.r ]r la;� .^.7y� k s r '�' � `f' �,t, �a � F. ' �' �'4 l„ µ n fii£ ti 1, x 1'sis r lu. $ 7c' ` .Fp r lc 1� w� �' a i4 ^' �' _vr `L.JIr�'+^y I, � 1 � j+ ,�;�t `- -�*,',{ � ,k. ��F�lif p l �tla,�L'"'9FEV'a }r� 1➢� :14, ( , ln�L`"� i7t�`a 1 7` {� ,,rY 5?�Yi i. '�,, , r'� vtill ,�., n�� T I'�a 411 511 r'' a I,GI�II ��aIM,�F I d�' I I ftl � u�3 I I �rNC�fil �}Z 7r4 ,# � IXL��. I� ,y5 L, I�+�y1) pf ��lr. � �lq �j`I }..r I C.�G ry �..,.�- fyi � T.14, +I Pa LlF�}��j�`yN rt"1'1T ,',, L�' -r ,,$� M ft44 1, i. P .`E+r � II�'�k'-y�r� ;�,, ��I� '�I� C �', , �u�t,�i it,',, R- I L3nil�Idl r '.F f � � '3 _'�'airb ��111" 1 1 �n W�J'lnl+�f �1f��.s�T..��� �y 1 � f �,+. � dT!lT�r'L. F Y„= � �,�- I"YM��1't/UI � ' I mWf ;11,,1 � � .� f 1 Rl �'{. (. ll ��� F Ca,?r � Y• SI I"".,,, 1 ° �',�r� I'-J�'l .+c'c.lp'� 7; � J. �M ��.0 � ulY§I�l l� ��,�� III-, , , ,,, ,oIL O l+�^et�V v��h ��T"� ll _ ^9r ,t—� I �` ka� nor Fs.� � �,�:1 i`�1 i 51 i�� 'l r/ GAIT �y��1 ili X i' e'4 ✓�II �..U�w��'"r'� �n�l M� � l,�Fil'�u i � �' ,zF'l �.�IaAII '�f l k R, 1 ICJ f�I � � �,�,j! ySI �k,-,4111,i,,,, �'"r��'0r4�� 88164 Cytopathology (conventional Pap ER), slides cervical or vaginal reported in Bethesda System, manual screening under physician supervision $17 31 , i 88165 Cytopathology (conventional Pap test), slides cervical or vaginal reported m Bethesda System, manual screening and rescreening under physician supervision $42 22 ,i, q , T 4 88141 Cytopathology (conventional Pap test), cervical or vaginal, any reporting system, requiring interpretation by physician $23 71 88142 Cytopathology (liquid -based Pap test) cervical or vaginal, collected m preservative fluid, automated thin layer preparation, manual screening under physician supervision $20 26 _ s 88143 Cytopathology, cervical or vaginal, collected m preservative fluid, automated thin layer preparation, manual screening and rescreening under physician supervision $23 04 ' ' 88174 Cytopathology, cervical or vaginal, collected m preservative fluid, automated thin layer preparation, screening by automated system, under physician supervision $25 37 , 88175 Cytopathology, cervical or vaginal, collected m preservative fluid, automated thin layer preparation, screening by automated system and manual rescreening, under physician supervision $26 61 U _ U , 87624 Human Papillomavirus (HPV) high-nsk types 10 $35 09 ` St 87625 Human Papillomavirus, types 16 and 18 only 10 $40 55 57452 Colposcopy of the cervix $131 49 57454 Colposcopy of the cervix, with biopsy and endocervica1 curettage $174 03 57455 Colposcopy of the cervix, with biopsy $166 88 S 57456 Colposcopy of the cervix, with endocervica1 curettage $157 57 57460 Colposcopy with loop electrode biopsy(s) of the cervix Requires WWC Preapproval Unless Done After HSIL or AIS Pap test $330 48 ' 57461 Colposcopy with loop electrode Ionization of the cervix Requires WWC Preapproval unless done after HSIL or AIS Pap test $367 49 , U , 57500 Cervical biopsy, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) Use this code for cervical polyp removal $162 00 57505 Endocervical curettage (not done as part of a dilation and curettage) $163 43 U 57520 Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair, cold knife or laser 11 $367 29 ' 57522 Loop electrode excision procedure 11 $314 92 U ' 58100 Endometnal sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) Only for diagnostic purposes following AGC Pap $105 41 U , ,,U `5 ,1 4 " 58110 Endometnal sampling (biopsy) performed m conjunction with Colposcopy (List separately in addition to code for primary procedure) Only for diagnostic purposes following AGC Pap $50 81 , 88305 Surgical pathology, gross and microscopic examination $74 12 $37 20 $36 92 88331 Pathology consultation during surgery, first tissue block, with frozen section(s), single specimen $105 74 $62 06 $43 68 88332 Pathology consultation during surgery, each additional tissue block, with frozen section(s) $56 93 $30 68 $26 25 88341 Immunohistochemistry antibody slide $90 51 $28 24 $62 27 88342 Immunohistochemistry antibody slide $104 79 $34 78 $70 01 88360 Morphometnc analysis, tumor immunohistochemistry, pre specimen, manual $123 78 $41 67 $82 11 88361 Morphometric analysis, tumor immunohistochemistry, pre specimen, using computer -assisted technology $123 63 $43 65 $79 97 99070 Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided) Various Pre -operative testing; CBC, urinalysis, pregnancy test, etc. These procedures should be medically necessary for the planned surgical procedure _ - - .. _ . 1.1m1 Notes 2023 ( O Rates 2_1)23 Prot ( 2(►) 21)23 1 e h ( I ( ) 400 Anesthesia for procedures on the integumentary system, anterior trunk, not otherwise specified 99156 10-22 minutes for individuals 5 years or older $75 hi 99157 For each additional 15 minutes 12 $62.27 End Notes 2023.CO Rates 2023 Prof (26) 2023 Tech (II') T OorS I' vruaLOGY FOR BOTH BREAST AND C. a, en -- a a ; A 1(AI., ( A .' '. ENIN(y .\ND) c i • 87-126 COVID-19 infectious agent detection by nuclei acid DNA or RNA; amplified probe technique IS $35.33 87635 COV I ID -19 infectious agent antigen detection by immunoassay technique; semiquantitative qualitative or IS $51.31 i 88365 In situ hybridization (eg,FISH), per specimen; initial single probe stain procedure $189.83 543 . 05 $146.78 88364 In situ hybridization (eg,FISH), per specimen; each additional single probe stain procedure $143.58 $34.07 $108.51 88 366 In situ hybridization (eg,FISH), per specimen; each multiplex probe stain procedure $293.45 $61.98 $231.46 88307 Morphometric stain procedure analysis, in situ hybridization, computer -assisted, per specimen, initial single probe $119.34 $33.32 $86.02 88373 Morphometric analysis, in situ hybridization, computer -assisted, per specimen, each additional probe stain procedure $71.70 $25.09 $46.66 88374 Morphometric analysis, in situ hybridization, computer -assisted, per specimen, each multiplex stain procedure $320.07 $42.62 $277 45 88368 Morphometric procedure analysis, in situ hybridization, manual, per specimen, initial single probe stain . $149.27 541.63 $107 64 88369 Morphometric analysis, in situ hybridization, manual, per specimen, each additional procedure probe stain $128.28 $33.01 S95 27 88377 Morphometric analysis, in situ hybridization, manual, per specimen, each multiplex stain procedure $417 83 $63.61 $354.22 Various Pre -operative testing; necessary for the CBC, urinalysis, pregnancy test, etc. These planned surgical procedure. procedures should be medically . ,, - _ � - - (pr CODES 1 � C�:� i 1. , ; ` �- \ilk Treatment of breast carcinoma in situ, breast cancer, cervical intraepithelial cancer. neoplasia and cervical 77061, 77062 Breast tomosynthesis, as screening, diagnostic, unilateral/bilateral. approved for coverage by CPED/WWC. These procedures have not been 13 87623 1 I uman Papillomavirus, low -risk types END NOTES FOR WWC C'LINIC4L SERVICES 1 All consultations should be billed through the standard "new patient" office visit CPT codes 99202-99205 Consultations billed as 99204 or 99205 must meet the criteria for these codes These codes (99204-99205) are typically not appropriate for CPED/WWC screening visits However, they may be used when provider spends extra time A do a detailed risk assessment 2 The 9938X codes shall be reimbursed at or below the 99203 rate, and 9939X codes shall be reimbursed at or below the 99213 rate The type and duration of office visits should be appropriate to the level of care needed to accomplish screening and diagnostic follow-up within the CPED/WWC While some programs may need to use 993XX-series codes, Preventive Medicine Evaluation visits are not covered by Medicare and not appropriate for the CPED/WWC 3 Fora bilateral breast ultrasound, a modifier 50 maybe added to either 76641 or 76642 to indicate a bilateral procedure The Medicare Physician Fee Schedule assigns a "1" bilateral indicator to both CPT codes 76641 and 76642 which means that Medicare will allow 150 percent of the standard reimbursement rate 4 List separately m addition to code for primary procedure 77067 5 List separately m addition to 77065 or 77067 6 Breast MRI can be reimbursed by the in conjunction with a mammogram when a client has a BRCA gene mutation, a first -degree relative who is a BRCA carrier, or a lifetime risk of 20% or greater as defined by risk assessment models such as BRCAPRO that depend largely on family history Breast MRI also can be used to assess areas of concern on a mammogram, or to evaluate a client with a history of breast cancer after completing treatment Breast MRI should never be done alone as a breast cancer screening tool Breast MRI cannot be reimbursed to assess the extent of disease in a women who has just been newly diagnosed with breast cancer in order to determine treatment 7 Codes 19081-19086 are to be used for breast biopsies that include image guidance, placement of localization device, and imaging of specimen These codes should not be used in conjunction with 19281-19288 8 Codes 19281-19288 are for image guidance placement of localization device without image -guided biopsy These codes should not be used in conjunction with 19081-19086 9 For CPT 10011 use the reimbursement rate for CPT code 10009 For CPT 10012 use the reimbursement rate for CPT code 10010 10 HPV DNA testing is not a reimbursable test for women under 30 years of age 11 A LEEP or comzation of the cervix, as a diagnostic procedure, may be reimbursed based on ASCCP recommendations Pre -approval of this procedure for reimbursement is required A LEEP or comzation of the cervix as a treatment procedure cannot be reimbursed by CDPHE 12 Example If procedure is 50 minutes, code 99156 + (99157 x 2) No separate charge allowed if procedure <10 minutes 13 These procedures have not been approved for coverage by Medicare Please see code 77063 as the approved code for screening digital breast tomosynthesis, bilateral 3D mammography 14 The carrier specific Medicare anesthesia conversion rates are available here https //www cros gov/Center/Provider-Type/Anesthesiologists-Center html Medicare's methodology for the payment of anesthesia services are outlined in the Medicare Claims Processing Manual, Chapter 12, pages 99-107, available here http //www sins hhs gov/manuals/downloads/c1m104c12 pdf 15 States have received federal funding and test kits for free COVD-19 testing These were specifically provided so that uninsured people could get free testing Since WWC/CPED is payor of last resort, this should be the first resource for any COVID-19 testing required by a provider prior to any procedure When testing cannot be covered by those resources for reasons such as the free testing only be administered to people who are symptomatic, then WWC/CPED can cover the required COVID-19 antigen testing If your organization pays for COVID testing, your organization should be able to track all tests results and link them to an actual screening or diagnostic procedure if the COVID-19 test is negative If the COVID-19 test is positive, your organization will need to have a plan for following up to make sure the required procedure gets done at a later date WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org Radiology Service Voucher This voucher is for the following patient who has been confirmed as eligible for: Este cupon es para las personas que son conftrmadas elegible para: o Women's Wellness Connection Program o TB Program Patient: Please present this voucher, as well as any other paperwork given to you, as you arrive for your radiology appointment to ensure proper billing. Your appointment is scheduled at: Al llegar a su cita por favor presente este cupon y otros documentos necesarios entregados a usted, para asegurar la facturacidn apropiada. Su cita es programada en: o Summit View Medical Commons 2001 70th Avenue, Greeley, CO 80634 (970) 810-6070 o North Colorado Medical Center 1801 16th Street, Greeley, CO 80631 (970) 810-4121 Appointment date/time: Patient's Date of Birth: Fecha de la cita Fecha de nacimiento Patient's name: Nombre del paciente Covered service for this visit: Servicio cubierto para esta cita °All other services will require prior authorization. Todos otros servicios se requieren autorizacidn previa. NOTE: This voucher expires 60 days after date of issue. Issue date: Authorized Signature: Service Provider: please bill Weld County as an insurance for the above listed service only: Weld County Department of Public Health Attn: Contract Billing 1555 North 17th Avenue, Greeley, CO 80631 If you have any questions or need to reschedule, please call (970) 304-6420. Si usted tiene alguna pregunta o tiene que cancelar la cita, por favor llame (970) 304-6420. Health Administration Public Health 8 Vital Records Clinical Services Tele: 970-304-6410 Tele: 970-304-6420 Fax: 970-304-6412 Fax: 970-304-6416 Environmental Health Communkafion, Emergency Preparedness Services Education 8 Planning g Response Tele: 970-304.6415 Tele: 970-304-6470 Teie:9,30,6470 Fax: 970-304-6411 Fax: 970-304-6452 Fax: 970-304-6452 Public Health Revised 11/2016 Contract F Entity Information Entity Name* Entity ID* BANNER IMAGING SERVICES @00043542 COLORADO LLC Q New Entity? Contract Name* Contract ID BANNER IMAGING SERVICES 6TH AMENDMENT FOR 7781 WWC DIAGNOSTIC IMAGING Contract Status CTB REVIEW Contract Lead * BFRITZ Contract Lead Email bfritz@weld.gov;Health- Contracts@weld.gov Contract Description * BANNER IMAGING SERVICES 6TH AMENDMENT FOR WWC DIAGNOSTIC IMAGING Contract Description 2 Contract Type* Department AGREEMENT HEALTH Amount* $1.00 Renewable* NO Automatic Renewal Grant IGA Department Email CM-Health@weldgov.com Department Head Email CM-Health- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Parent Contract ID Requires Board Approval YES Department Project # Requested BOCC Agenda Due Date Date* 01 /25/2024 01/29/2024 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Contact Info Review Date * 05/20/2027 Committed Delivery Date Renewal Date Expiration Date* 07/20/2027 Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head JASON CHESSHER DH Approved Date 02/09/2024 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 02/21/2024 Finance Approver CHERYL PATTELLI Legal Counsel BRUCE BARKER Finance Approved Date Legal Counsel Approved Date 02/09/2024 02/12/2024 Tyler Ref # AG 022124 Originator BFRITZ Hello