Pay per view: Implement the new ESA transmittals in your hospital
APCs Weekly Monitor, July 4, 2008
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Train your coding and clinical staff for ESA billing changes
Why was a national coverage determination (NCD) made for ESAs, when drug and biologicals are usually managed at the local coverage determination (LCD) level? NCDs can occur ?when there are safety issues, questions regarding efficacy of a drug, significant cost of a drug to the Medicare system, or a high impact to a number of Medicare beneficiaries,? said Jennifer McPeek, BSN, OCN, nursing program manager at the James Cancer Hospital in Columbus, OH.
McPeek explained that LCDs are created by individual MACs, carriers, or FIs when no NCD exists. The LCD cannot directly conflict with the NCD.
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