In Coding
Mar 3rd, 2014
The Centers for Medicare & Medicaid Services (CMS) has removed the coverage of evidence (CED) requirement in the national coverage determination (NCD) for fluorodeoxyglucose (FDG) positron emission tomography (PET) for solid tumors, effective June 11, 2013. CMS will cover three FDG PET scans (without the CED requirement) when used to guide subsequent management of anti-tumor ...
Mar 1st, 2013
By Lynn S. Berry, PT, CPC Over the last three decades, there has been remarkable change in therapy services billing rules due to legislative efforts to bring the cost of health care down and to pay for the quality (rather than quantity) of care. Therapists must juggle clinical concerns with documentation burdens to meet the ...
Jul 1st, 2012
By Susan M. Edwards, CPC, CEDC Correct coding and billing for durable medical equipment (DME) raises many questions, such as: What constitutes DME? Besides the order and physician signature, what other information do I need to submit a claim? Are there modifiers? To shed some light on ambiguous areas, we’ll answer these questions and more. ...
In Billing
Aug 31st, 2011
Effective for claims with dates of services on or after July 7, 2011 magnetic resonance imaging (MRI) is a covered service for beneficiaries with implanted pacemakers. The Centers for Medicare & Medicaid Services (CMS) is changing the language in section 220.2.C.1 of the Medicare National Coverage Determination Manual to remove the contraindication for Medicare coverage ...
In Billing
Nov 29th, 2010
The Centers for Medicare & Medicaid Services (CMS) recently clarified billing instructions for positron emission tomography sodium fluoride-18 (PET NaF-18) scans for identifying bone metastasis of cancer in the context of a clinical trial and by correcting applicable codes that can be billed with this service. PET NaF-18 Clarified, Corrected was last modified: July 5th, 2011 by ...