Recent Recovery Auditor activity
Medicare Insider, May 6, 2014
Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!
CGI posts two new issues in one category
CGI posted two new issues in one category to its CMS list for providers in Region B. (See link for individual state applicability.)
For outpatient services at Critical Access Hospitals:
· The Cardiovascular Nuclear Medicine services have coverage guidelines specific to the Local Coverage Documentation and the CMS Manuals in Ohio and Kentucky. Decision-making for testing is based upon the presence of multiple clinical risk factors, the level of functional capacity, the risk of the surgery and the likelihood that the results of the cardiac testing would change the management. There are specific diagnoses associated with each form of testing. When an unapproved diagnosis is reported for any type of Cardiovascular Nuclear Medicine service, the service is denied.
· The Cardiovascular Nuclear Medicine services have coverage guidelines specific to the Local Coverage Documentation and the CMS Manuals in Michigan and Indiana. Decision-making for testing is based upon the presence of multiple clinical risk factors, the level of functional capacity, the risk of the surgery and the likelihood that the results of the cardiac testing would change the management. There are specific diagnoses associated with each form of testing. When an unapproved diagnosis is reported for any type of Cardiovascular Nuclear Medicine service, the service is denied.
Want to receive articles like this one in your inbox? Subscribe to Medicare Insider!
Related Products
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Residency coordinators’ responsibilities
- RPA Subscriber Exclusive: February issue of Residency Program Alert now available
- Study: Shorter shifts reduces residents’ attentional failures
- Practice the six rights of medication administration
- Editor’s note
- Nursing responsibilities for managing pain
- The consequences of an incomplete medical record
- Prevent dehydration with nursing interventions
- Q&A: Primary, principal, and secondary diagnoses
- E-mailed
-
- White Paper: Postacute CDI: An Introduction to Long-Term Acute Care Hospitals
- Use modifiers -59, -91 to "explain" duplicate codes
- Tim Porter-O'Grady sounds off
- Q: Can you clarify the reporting of dates on the plan of care for diagnosis onset and exacerbation?
- ICD-10-CM coma, stroke codes require more specific documentation
- Fracture coding in ICD-10-CM requires greater specificity
- Eight tips to improve MRI throughput
- Searched