Southeast Community and Technical College provides a health plan for students through the Appalachian Regional Hospital (ARH).
Benefits include unlimited visits for illness or injury involving the CPT codes listed below, with primary medical care staff of clinics with location near SKCTC campuses during normal business hours of the clinics. A CPT (Current Procedural Terminology) code is a number used for insurance purposes and assigned to every service a medical practitioner can provide.
Clinics include:
- ARH - Whitesburg Daniel Boone Clinic
- ARH - Harlan Daniel Boone Clinic - ARH Prime Time Clinic Harlan
- ARH - Cumberland Clinic
- Middlesboro - Dr. Maria Hortillosa, 3513 Cumberland Avenue
- Middlesboro - Dr. CA Moore, 123 N. 19 th Street
- Knox Family Medicine-Barbourville
Benefits for primary medical care
The plan includes visits to family practitioners, general internal medicine specialists, pediatricians, and gynecologists, and nurse practitioners and physicians assistants who specialize in primary care. These general office visit CPT codes are included:
- 98201
- 99202
- 99203
- 99204
- 99211
- 99212
- 99213
- 99214
Additional benefits
- Laboratory tests included in the covered services defined for Routine Rural Health Clinics, (hemacult, pin worms, hemoglobin, glucose test, strep screen, and gram stain); and plain-film x-ray associated with primary care provider evaluation of illness and injury at the above mentioned clinics. Other imaging services, such as ultrasound, CT and MRI will be available at the normal clinic charge .
- One routine gynecological exam per year for women, including PAP smears. Mammography services and STD test kits will be available at the normal clinic charge for such service.
- One well-patient physical per year, if needed by students to complete required forms for outside agencies. ARH will provide unlimited copies of the report as requested by the student.
- One flu shot.
- Additional laboratory tests to include PSA test (CPT Code 84153), coronary risk profile (CPT Code 80061), random blood sugar (CPT Code 82962) and total cholesterol (CPT Code 82465).
- Nursing services associated with allergy shots and immunizations, if the antigens are provided by the student prior to scheduling the shot . (CPT 90471 and 90472)
- Over the counter medications for cold and flu.
- Minor Surgery associated with Accident/Injury care limited to the following minor procedures with 0 to 10-day post-operative management, within the following CPT codes: CPT 12001 , 12002 , 12004 , 12011 , 12013 , 16020 , 20520 , 26010 , 27086 , 28190 , 30901 , 29105 , 29125 , 29126 , 29130 , 29131 , 29200 , 29220 , 29240 , 29260 , 29280 , 29505 , 29515 , 29520 , 29530 , 29540 , 29550 .
- Mental health services limited to a psychiatric diagnostic interview examination, which may be provided by a nurse practitioner, physician assistant, mental health counselor, medical social worker, or family practitioner.
- In the basis of the above psychiatric diagnostic interview, ARH practitioners may provide referral to other mental health providers for purposes of therapeutic follow up. ARH will not be responsible for the cost of follow up care.
Where available at the clinics, ARH may also enroll students in ARH chronic care programs (for example, the Diabetes management program).
Covered CPT Codes
Code | Explanation |
12001 |
Simple repair of superficial wounds up to 12.5cm, head & body excluding face |
12002 |
|
12004 |
|
12011 |
Simple repair of superficial wounds face |
12013 |
|
16020 |
Dressing and/or debridement, initial or subsequent; without anesthesia, small |
20520 |
Removal of foreign body in muscle or tendon sheath, simple |
26010 |
Drainage of finger abscess, simple |
27086 |
Removal of foreign body, pelvis or hip, subcutaneous tissue |
28190 |
Removal of foreign body, foot, subcutaneous, simple |
29105 |
Application of long arm splint (shoulder to hand) |
29125 |
Application of short arm splint (forearm to hand); static |
29126 |
Application of short arm splint (dynamic) |
29130 |
Application of finger splint; static |
29131 |
Application of finger splint; dynamic |
29200 |
Strapping; thorax |
29220 |
Strapping; low back |
29240 |
Strapping; shoulder |
29260 |
Strapping, elbow or wrist |
29280 |
Strapping, hand or finger |
29505 |
Application of long leg splint, thight to ankle or toes |
29515 |
Application of short leg splint, calf to foot |
29520 |
Strapping, hip |
29530 |
Strapping, knee |
29540 |
Strapping, ankle and/or foot |
29550 |
Strapping, toes |
30901 |
Control nasal hemorrhage, anterior, simple, limited cautery &/or packing, any method |
Covered Evaluation and Management Codes
Code | Explanation |
99201-99204 |
New Patient - a minor service provided,maximum 10 min. to a moderate to high severity typically taking around 45 min. |
99211-99214 |
Established Pt. - 5 minutes -moderate to high severity typically taking 25 minutes. |
|
(There are multiple factors involved in choosing the correct code and normally it takes a professionally trained person.) |