In CMS
Aug 12th, 2019
Expensive cutting-edge cancer therapy is now covered. Last week the Centers for Medicare & Medicaid Services (CMS) finalized their long-awaited decision to make Chimeric Antigen Receptor T-cell (CAR T-cell) therapy, a type of cancer treatment that uses a patient’s own genetically modified immune cells to fight cancer, available to Medicare patients nationwide. This determination enables ...
In Billing
Feb 14th, 2019
The Centers for Medicare & Medicaid Services (CMS) released, Feb. 1, maintenance updates for several National Coverage Determinations (NCDs) to reflect recent code changes (CR11134). Every year, when ICD-10, CPT®, and HCPCS Level II codes are updated, NCDs (and Local Coverage Determinations) must also be updated. When this occurs, it’s essential for providers to review ...
In Billing
Oct 23rd, 2018
An important update has been made to the Medicare National Coverage Determinations (NCD) Manual regarding coverage of magnetic resonance imaging (MRI) for patients with certain implantable cardiac devices. In a National Coverage Analysis (NCA), the Centers for Medicare & Medicaid Services (CMS) determined there is sufficient evidence to conclude MRI for patients with certain implantable ...
In Coding
Jun 6th, 2018
The answers to proper medical coding and reimbursement are not always transparent. From the referral to the claim submission, there are many opportunities for errors that result in a claim denial, improper payment, or even an audit. To secure proper payment, here is a checklist of five essential questions to ask yourself as you code ...
May 21st, 2018
Twenty-three National Coverage Determinations (NCDs) for clinical diagnostic laboratory services have been updated to reflect the April 2018 quarterly release of the edit module for such services. ICD-10-CM codes in effect April 1 affect coverage for several common lab tests. Note ICD-10-CM Code Changes in Lab NCDs The following lab NCDs add/delete ICD-10-CM codes from the ...