Part B Insider (Multispecialty) Coding Alert
Understand The National Coverage Process
Published on Sun Apr 23, 2006 
PDF
PDF
CMS is offering more clarity on how it decides which local coverage determinations (LCDs) will become national policy. The agency has issued two guidance documents that detail steps in the national coverage determination (NCD) process concerning CMS' determinations of whether an item or service is reasonable and necessary.
The guidance explains the factors CMS considers when initiating a Medicare NCD and determining whether to commission an external health technology assessment (HTA) to evaluate a new health care technology, the agency says in a release. You can find more information online at the CMS Web site www.cms.hhs.gov/MedicareCoverageGuideDocs/.
Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- ICD-9 CODES:
New Torsion, Mental Status Codes May Help You Reap Reimbursement
Start mastering the new ICD-9 Codes now
With new ICD-9 codes on [...] - DENTAL SERVICES:
2 Practices Succeed In Overturning 'Routine' Dental Denials
Medicare will cover dental services when they're medically related
Don't take a denial of "routine" services [...] - AUDITS:
Every Minute Counts When You Respond To Prepayment Audits
Start a dialogue with your carrier, and get your physician involved
When it comes to dealing [...] - AUDITS:
Get To The Bottom Of Audits--And Come Out On Top
Download carrier scoresheets from the Web
Why do bad audits happen to good coders?
Asking why your [...] - Democrats Trying To Overturn Deficit Reduction Act
Congressional representatives are now hopping on the bandwagon to defeat the Deficit Reduction Act, which [...] - EMERGENCY CARE:
Coding For Suture Depends On The Future
Use 54 modifier if ED physician doesn't plan to remove sutures
Question: A patient comes into [...] - Understand The National Coverage Process
CMS is offering more clarity on how it decides which local coverage determinations (LCDs) will [...] - ORTHOPEDIC:
Reader Question--Don't Forget ICD-9 Code When You Report Finger Amputation
Question: We have documentation for a 37-year-old male patient who accidentally injured his left hand [...] - OPHTHALMOLOGY:
Opt For Modifier GY For Never-Covered Services
Helpful hint: No ABN necessary
When your ophthalmologist performs a service that Medicare never covers, do [...] - PATHOLOGY:
Find FOBT Coding Success From 82270 To 82274
Double-check method--and specimen
Billing rules for fecal occult blood test (FOBT) have [...] - NEUROLOGY:
Say Goodbye To 436 And Hello To 434.9x For Stroke
Bonus: New code will allow for reimbursement on some noncovered services
If you've been receiving denials [...] - FAMILY PRACTICE:
Ensure Payment For Diabetes Counseling By Verifying Frequency Allowances
Also: If you don't include a diabetes diagnosis on your claim, expect a denial
Scenario: You're [...] - GENERAL SURGERY:
Turn To Modifier 24 For Post-Op Evaluations
Caution: Only use it when complications arise
You do have the option [...] - ONCOLOGY:
Reader Question--Minutes Make The Difference For Colorectal Cancer Coding
Question: I have documentation for a patient with metastatic colorectal cancer (primary neoplasm of the [...] - Part B Coding Coach:
Tackle TENS Unit Coding With These
Learn why the correct codes are key to proper reimbursement.
Coding for transcutaneous electrical nerve stimulation [...] - PHYSICIAN NOTES:
Secrets Of E/M Documentation Are On The CMS Site
Learn the ABC's of AV fistulas
Need a refresher course in evaluation and management (E/M) documentation? [...]
View All