NCD and LCD: All billing and coding professionals must follow National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) as these provide Medicare coverage rules for wound care and ensure apt reimbursements. Medicare coverage rules include utilization and documentation guidelines, cove...
policy addresses only spinous process fixation orthoses, which are intended for fixation or fusion rather than as motion preserving devices. There are a number of spinous process fixation orthoses under investigation, some of which have received approval for marketing from the U.S. Food and Drug...
. Medical technologies lacking an NCD or LCD can still have implicit coverage if the technology aligns with an established code that describes its use in clinical practice. However, reimbursement of novel medical technologies is unreliable when no coverage determinations exist, and when implicit ...
Here in Medicare Advantage, what is so different is that the claims for money are really being made by the payers. They’re getting the money from the government and then they’re providing the medical services. To go to your question, what we’re seeing happen is a change really in the...