Conflict arises in 2015 when Medicare coverage doesn’t align with CDC recommendations. By Susan Theuns, PA-C, CPC, CHC Coding pneumonia vaccine immunization for Medicare beneficiaries age 65 and over is tricky. Recent Centers for Disease Control and Prevention (CDC) recommendations and Medicare coverage guidelines do not align, causing discrepancy between what the healthcare provider may ...
In Billing
Jul 13th, 2012
The Centers for Medicare & Medicaid Services (CMS) has expanded extracorporeal photopheresis (ECP) coverage for the treatment of bronchialitis obliterans syndrome (BOS) following lung allograft transplantation when processing claims with service dates on or after April 30. This policy change expands coverage only for when ECP is provided under a clinical research study that meets specific asses...
Jun 1st, 2012
The Centers for Medicare & Medicaid Services (CMS) recently revised the National Coverage Determination (NCD) for Extracorporeal Photopheresis (110.4) to add coverage for the treatment of bronchiolitis obliterans syndrome (BOS) following lung allograft transplantation. Medicare coverage is effective for services rendered on or after April 30, 2012 when provided under a clinical research study a...
In Billing
Mar 2nd, 2012
In the Medicare FFS Provider e-News for Feb. 22, under the Claims, Pricer and Code Updates heading, is a so-called “resolution” from the Centers for Medicare & Medicaid Services (CMS) for providers receiving the 496 edit on electronically filed claims using the new 5010 transaction standard. According to CMS, since the implementation of Version 5010 ...
Jan 1st, 2011
By Jill M. Young, CPC, CEDC, CIMC Chronic obstructive pulmonary disease (COPD) is a progressive disease that causes coughing, wheezing, shortness of breath, chest tightness, and other symptoms. The leading cause of COPD is smoking; most people who smoke, or have smoked, have some form of COPD. In 2007, an estimated 12.1 million Americans had ...