DR. ALTON LEE HUNTER M.D.
NPI 1801849062
Orthopaedic Surgery in Columbia, TN

Medicare Participation & PECOS Enrollment Status

Alton Hunter is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Alton Hunter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 6305930272

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20100419000278

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L3807)

  1 DME suppliers used 20 Medicare Claims 20 Services Paid

• DME-Orthotic Devices (DF000N)

  Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf (HCPCS:L3908)

  1 DME suppliers used 76 Medicare Claims 89 Services Paid

• DME-Orthotic Devices (DF000N)

  Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf (HCPCS:L3924)

  1 DME suppliers used 27 Medicare Claims 29 Services Paid

• DME-Orthotic Devices (DF000N)

  Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment (HCPCS:L3984)

  1 DME suppliers used 17 Medicare Claims 17 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of elbow to finger cast

An elbow to finger cast is applied to immobilize the arm from the elbow down to the fingers. This aids in healing fractures or severe sprains. The cast, made from plaster or fiberglass, wraps around the arm, providing support and limiting movement to promote recovery.

This service was performed 24 times for 21 patients

Aspiration and/or injection of cyst of tendon

Aspiration and/or injection of a tendon cyst is a procedure where a needle is used to remove fluid from a cyst located in a tendon. In some cases, medication might be injected to help reduce inflammation and alleviate pain.

This service was performed 12 times for 11 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 19 times for 16 patients

Aspiration and/or injection of fluid from medium joint

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

This service was performed 45 times for 41 patients

Aspiration and/or injection of fluid from small joint

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

This service was performed 37 times for 33 patients

Cast supplies, short arm cast, adult (11 years +), fiberglass

A short arm cast, made from fiberglass, is often used for fractures or injuries to the wrist or forearm in adults and children over 11. It's lightweight, durable, and can be molded to fit your arm comfortably. This cast allows for limited movement while ensuring proper healing.

This service was performed 22 times for 19 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 339 times for 264 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 322 times for 265 patients

Finger splint, static

A static finger splint is a device used to immobilize your finger, keeping it in a fixed position. This aids in healing by preventing movement that could cause further injury. It's often used for conditions like fractures, dislocations, or sprains.

This service was performed 33 times for 21 patients

Fusion of finger joint, initial joint

Fusion of the initial finger joint is a surgical procedure aimed at relieving pain and improving function. The surgeon joins two bones in the finger, creating a single, more stable unit. This procedure may reduce flexibility, but it can significantly alleviate discomfort.

This service was performed 11 times for 11 patients

Imaging guidance for procedure, 60 minutes or less

Imaging guidance is a procedure where real-time images are used to direct medical tools during a treatment. This technique helps to improve accuracy and safety. The procedure typically lasts 60 minutes or less.

This service was performed 39 times for 37 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 40 times for 29 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 203 times for 156 patients

Injection of carpal tunnel

An injection for carpal tunnel is a treatment to reduce inflammation and swelling in your wrist, which can alleviate pain and numbness. The doctor injects a steroid medication into your wrist area to provide relief.

This service was performed 59 times for 51 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 16 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 84 times for 43 patients

Nerve conduction, 9-10 studies

Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.

This service was performed 36 times for 35 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 53 times for 53 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 88 times for 88 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 41 times for 41 patients

Relocation of tendon of forearm and/or wrist

Relocation of a tendon in the forearm or wrist is a surgical procedure aimed to improve joint function. It involves moving a tendon from its original position to a new one to enhance mobility or correct a deformity. It's typically done under general anesthesia.

This service was performed 25 times for 24 patients

Removal of bone joints between wrist and fingers

This procedure involves the surgical removal of bone joints between your wrist and fingers. It's typically done to relieve pain or restore function due to conditions like arthritis. After removal, the space may be filled with a graft or artificial joint.

This service was performed 25 times for 24 patients

Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device

This treatment involves repairing multiple fractures in the lower forearm near the thumb side of the wrist. A device is placed to stabilize the area, promoting proper healing. This procedure helps restore function and minimize discomfort.

This service was performed 13 times for 13 patients

Upper limb (arm) arthroscopy (minimally invasive joint repair)

Upper limb arthroscopy is a minimally invasive procedure used to examine and treat issues within your arm's joints. A small camera, called an arthroscope, is inserted through a tiny incision, providing a clear view of the joint. This method often results in less pain and faster recovery compared to open surgery.

This service was performed for 14 patients

X-ray of elbow, 2 views

An elbow X-ray, 2 views, is a quick, painless imaging test. It uses a small amount of radiation to produce detailed images of your elbow from two different angles. This helps in diagnosing conditions like fractures, infection, or arthritis. It's a safe and effective way to monitor your elbow health.

This service was performed 31 times for 28 patients

X-ray of finger, minimum of 2 views

An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.

This service was performed 32 times for 19 patients

X-ray of hand, minimum of 3 views

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

This service was performed 502 times for 316 patients

X-ray of wrist, 2 views

An X-ray of the wrist, 2 views, is a diagnostic procedure where two different images of your wrist are taken using a small amount of radiation. This helps identify any abnormalities or injuries such as fractures or arthritis. It's a quick, non-invasive process.

This service was performed 63 times for 34 patients

X-ray of wrist, minimum of 3 views

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

This service was performed 136 times for 101 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.38 for a new patient copayment and $16.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 38401 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 75 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: N/A

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: N/A

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Alton Hunter is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1801849062 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

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The following 20 providers are registered at the same or nearby location.

Frequently Asked Questions