Q: When a physician schedules a procedure, do you evaluate the patient’s record prior to the procedure to determine whether all of the coverage requirements of the applicable National Coverage Determinations and/or Local Coverage Determinations are met?Read More »
Q: Over the last few weeks, there have been quite a few articles in various newsletters about device credits. I’m not sure we have the best process in place to identify recalls and under-warranty replacements so I took a look. In the first account I reviewed, I found an item from a St. Jude...Read More »
Q: Are outpatient departments considered part of the therapy cap for hospital-owned facilities? If so, do we need to bill with modifier –KX (Type of Bill 012X)? I want to ensure I’m billing correctly.Read More »
Q: Can a hospital bill for orthotic or prosthetic supplies (e.g., leg brace for a patient in the ED or clinic) on the hospital claim? What are the requirements for billing these supplies? Is revenue code 0274 the correct revenue code? Are HCPCS codes needed?Read More »