PYA Principal Valerie Rock was recently quoted in “MACs Move Codes from LCDs to Local Coverage Articles; TPEs May Be Based on the Latter,” an article about the Centers for Medicare & Medicaid Services’ (CMS) requirement that Medicare Administrative Contractors (MACs) move CPT and ICD-10-CM codes from local coverage determinations (LCDs) to local coverage articles and the effect that is having on providers.
[Valerie] Rock thinks [the change] seems like an improvement because hospitals won’t have to sort through clinical policy language to find the codes that are covered for a service that has been ordered for the patient. “Coding and billing policies are not clinical issues, and [CMS] wanted to move that to a separate document,” she explains.
Read the full article from the Report on Medicare Compliance, a publication of the Health Care Compliance Association.
If you would like more information about complying with LCDs or medical necessity, or would like assistance with any matter involving coding and compliance, pre-transaction reviews, or reimbursement, contact a PYA executive below at (800) 270-9629.