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Wiki Medical medical necessity for MAC

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lr09050828@gmail.com

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If you posting a Colon/EGD for MAC anesthesia service do you still have to get a medical necessity code for a 00813 for Medicare and commercial medicare. It’s not stating on the LCD35049. And if so where would i go to find out you do or link. TIA
 
Yes, you need to check your MAC's LCD diagnosis list for Monitored Anesthesia Care, and submit a code on that list that is documented on the anesthesia record.
 
I believe MAC lcd is article# A57361. Check the medical records if patient has history or review of systems: hypertension, renal disease, CAD, hypothyrodism or other comorbidities-check the lcd list and add any of those dx to your claim.
 
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