REIMBURSEMENT 148 Section 2 CLINICAL CLASSIFICATION SYSTEMS AND CASE 2-39 Nation
ID: 305887 • Letter: R
Question
REIMBURSEMENT 148 Section 2 CLINICAL CLASSIFICATION SYSTEMS AND CASE 2-39 National Coverage Determination (NCD) admissions clerk in determining it i are a compliance coordinator. Part of your job is to assist the a e will cover services ordered or if an advanced beneficiary notice needs to be given. You developing a table for the admission clerks to cross-reference when admitting patients. To accomplih in Table 2-24 and fill in the rest of the table. NCDs can be found on the Internet at http:/www.cms hbs n also find a direct link to NCDs in the web links section of the student companion webwite need to look up the national coverage determination (NCD) for each procedure idenüified gow. You ca Table 2-24 National Cosvenge Dvterm Ietermination (NCD) Table National Couerage Determination (NCD) Medicare Coverage?Limitations? Date NCD Section Procedure Prosthetic shoe Cytogenetic studies Treatment of actinic keratosis PET for perfusion of the heart Colonic irrigation Vitrectomy Gastric freezing Ambulatory EEG monitoringExplanation / Answer
1) procedure: prosthetic shoe:it is benefit categories in medicare and limitation is that it can be covered as terminal device and the coverage of artifical arms and legs includes payment for terminal devvices such as hooks, NCD section is 280.10,implementation dates : on or after march 2, 2006, 2)cytogenetic studies:benefit category, medicare covers these tests when they are reasonable and necessary for the diagnosis or treament of the following condition they are genetic disorders,failure of sexual development, chronic myelogenous leukemia, acute leukemia lymphoid, mylodysplasia. implementation date is 7/16/1998, NCD section is 190.3 3)Treatment of actinic Keratosis: benefit category: physician assisted services, limitation: effective for services performed on and after november 26, 2001 medicare covers the destructionof actinic keratoses without restrictions based on lesion or patient charateristics..NCD section: 250.4. 4)PET for perfusion of the heart:Benefit category ; diagnostic tests: indications and limiation: rubidium 82( effective march 14 1995) and ammonia N-13( effective october 1 , 2003) NCD section:220.6.1. 5)Colonic irrigation: Benefit category: physician services, this may not be an exhaustive list of all applicable Medicare benefits categories for this service, limitations and indications: there are no conditions for which colonic irrigation is medically indicated and no evidence of therapeutic value accordingly colonic irrigation cannot be considered reasonable and necessary within the meaning of section 186(a)(1) of the act, NCD section: 100.7. 6)vitrectomy: Benefit category: Ambulatory surgical center facility services and physicans services, this may be a an exhaustive list of all applicable medicare benefits categories for this service, limitations and indications: it may be considered reasonable and necessary for the conditions like incident of cataract surgery, proliferative retinopathy and vitreous opacities etc.NCD section 80.11.implementation date is 6/19/2006. 7)Gatric freezing: it is an physicians services, limitations and indications of coverage: since the procedure is now considered obsolete it is not covered, NCD section is 100.6. implementation date is february 21, 2006. 8)Ambulatory EEG monitoring:it is diagnostic test this may be an exhaustive list of all applicable medicare benefits categories for this service, indications and limitations of coverage: it is a diagnostic procedure for patients in whom a seizure diathesis is suspended but nor defined by history , physical or resting EEG. Ambulatory EEG can be utilized in the differential diagnosis of suncope and transient ischemic attacks if not eluciated by conventional studies it is always preceded by a resting EEG . NCD Section:160.22. implementation date is april , 2, 2002.
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.