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Monday, April 7, 2014. Drill Down: Cetuximab and Medical Necessity - April 7, 2014. April 7, 2014. Drill Down: Cetuximab and Medical Necessity. Written by Margaret Klasa, DC, APN, Bc. Created on Tuesday, 08 April 2014 12:42. The issue references Wisconsin Physicians Service Insurance Corporation’s Local Coverage Determination (LCD): Chemotherapy Drugs and their Adjuncts (L28576) which specifically lists the ICD codes for Cetuximab:. Cetuximab (Erbitux TM) (J9055) 10 mg. Cetuximab is covered when:. The pa...

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Monday, April 7, 2014. Drill Down: Cetuximab and Medical Necessity - April 7, 2014. April 7, 2014. Drill Down: Cetuximab and Medical Necessity. Written by Margaret Klasa, DC, APN, Bc. Created on Tuesday, 08 April 2014 12:42. The issue references Wisconsin Physicians Service Insurance Corporation’s Local Coverage Determination (LCD): Chemotherapy Drugs and their Adjuncts (L28576) which specifically lists the ICD codes for Cetuximab:. Cetuximab (Erbitux TM) (J9055) 10 mg. Cetuximab is covered when:. The pa...

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In Context | context4healthcare.blogspot.com Reviews

https://context4healthcare.blogspot.com

Monday, April 7, 2014. Drill Down: Cetuximab and Medical Necessity - April 7, 2014. April 7, 2014. Drill Down: Cetuximab and Medical Necessity. Written by Margaret Klasa, DC, APN, Bc. Created on Tuesday, 08 April 2014 12:42. The issue references Wisconsin Physicians Service Insurance Corporation’s Local Coverage Determination (LCD): Chemotherapy Drugs and their Adjuncts (L28576) which specifically lists the ICD codes for Cetuximab:. Cetuximab (Erbitux TM) (J9055) 10 mg. Cetuximab is covered when:. The pa...

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context4healthcare.blogspot.com

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In Context: June 2013

http://context4healthcare.blogspot.com/2013_06_01_archive.html

Tuesday, June 18, 2013. Drill Down – Canceled Elective Surgery but not Reimbursement. This week, RAC Region A contractor Performant has posted a complex audit issue – Canceled Elective Surgeries for Acute Inpatient Hospital providers. Performant is reviewing all canceled elective surgeries that did not occur but the hospital billed for the admission and would be paid only if the surgery was considered reasonable and necessary despite the cancelation of the elective surgery. Elective surgery is generally.

2

In Context: October 2013

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Thursday, October 31, 2013. October 29, 2013. Drill Down – Pre-Admission Services. One of the references listed for this issue is the CMS 100-04 Medicare Claims Processing Manual, Chapter 3, Section 40.3:. A Outpatient Services Followed by Admission Before Midnight of the Following Day (Effective For Services Furnished Before October 1, 1991). B Preadmission Diagnostic Services (Effective for Services Furnished On or After January 1, 1991). Drugs incident to other diagnostic services. 0341, 0343 -. Nucle...

3

In Context: March 2014

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Tuesday, March 25, 2014. March 25, 2014 Drill Down – Polysomnography Reported with Incorrect Diagnosis. March 25, 2014. Drill Down – Polysomnography Reported with Incorrect Diagnosis. That was published in October 2013 and the Centers for Medicare and Medicaid Services (CMS) publication 100-02 Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services, Section 70 - Sleep Disorder Clinics. RAC Issues for the Week of March 24 – March 28, 2014:. RAC Region B CGI. An issue exists ...

4

In Context: December 2013

http://context4healthcare.blogspot.com/2013_12_01_archive.html

Wednesday, December 18, 2013. December 17, 2013. Drill Down – Herceptin Multi-dose Vial Waste Targeted by OIG and WellPoint. It’s been a slow month for the RAC contractors with only RAC Region A Performant and RAC Region C Connolly recently posting issues for December. However, I’d like to discuss with you how a previously posted issue by RAC contractors Performant, Connolly and HDI, are reverberating through the payer industry at large. An error rate of 77% of Medicare claims for Herceptin multi-use via...

5

In Context: May 2013

http://context4healthcare.blogspot.com/2013_05_01_archive.html

Wednesday, May 29, 2013. Drill Down – Why LCDs are Your Starting Point. May 28, 2013. As a provider, knowing your LCDs should be the starting point to Medicare patient encounters - from what is covered and what is not, to documentation required, code combinations and utilization. Providing products and services that are not covered by Medicare and not securing a signed. Other RAC issues for the week of May 27. RAC Region A Performant. Physician /Non-Physician Practitioner Claim Types. Filgrastim Billed w...

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Choose Your Industry Brief. Stay current on industry trends and issues. Optimize your revenue cycle with critical insights into claim compliance and reimbursement issues. Help detect FWA and avoid the "Pay and Chase" model through education and in-depth insights. Choose Your Industry Brief. DecisionPoint Health Payment System. Custom Physician Fee Reports. Our News and Events page keeps you up to date on what we're working on next. Works closely with many partners, passing on the benefits to our clients.

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Monday, April 7, 2014. Drill Down: Cetuximab and Medical Necessity - April 7, 2014. April 7, 2014. Drill Down: Cetuximab and Medical Necessity. Written by Margaret Klasa, DC, APN, Bc. Created on Tuesday, 08 April 2014 12:42. The issue references Wisconsin Physicians Service Insurance Corporation’s Local Coverage Determination (LCD): Chemotherapy Drugs and their Adjuncts (L28576) which specifically lists the ICD codes for Cetuximab:. Cetuximab (Erbitux TM) (J9055) 10 mg. Cetuximab is covered when:. The pa...

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