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Urology Coding Alert

Reimbursement Roundup:

Review Your Lupron Coding and Payments to Ensure Accurate Reimbursement

Published on Sat Apr 17, 2010

Your Medicare contractor can't use the least costly alternative payment method anymore -- so keep an eagle eye on your EOBs. If your practice gets hit with reduced reimbursement every time you submit a Medicare claim for Lupron, you're in luck. CMS determined they will no longer enforce their least costly alternative (LCA) policies. Make sure you have all the details to ensure your practice gets the money you deserve. Expect Full Pay as of April 19, 2010 In February, CMS lost a lawsuit regarding its LCA policy. As a result, all Medicare contractors must pay for Part B drugs according to the particular drug the patient actually received, not the price of the lowest cost alternative drug for which they were paying in the past. The history: The American Association of Clinical Urologists (AACU, www.aacuweb.org) posted the resulting policy update on its Web site. According to the AACU site, [...]
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