Skip to main content

Role of NCDs and LCDs in Medical Coding and RCM -Avontix


There are two important aspects of Medicare coverage that play a pivotal role in medical coding and revenue cycle management: National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). Both the NCDs and LCDs are released by the Centers for Medicare and Medicaid Services (CMS) with the purpose of standardizing Medicare coverage for some specific medical tests and treatments or procedures. These determinations provide the guidelines which are useful in determining whether a service is considered by Medicare coverage. NCDs and LCDs play a crucial role in the revenue cycle management because these are tools that assist healthcare providers in submitting accurate claims for reimbursement.

NCDs:
National Coverage Determinations are applicable nationwide in the US to specify the Medicare coverage of certain services. All Medicare contractors ought to follow the NCDs.

LCDs: 
Local Coverage Determinations are made based on medical necessity and are released by Medicare contractors. LCDs are applicable only to the contractor’s region.

In cases where an item or service is not covered by NCD, the local contractor has to take responsibility for the decision for its coverage. Both NCDs and LCDs define policies specifically for an item or service and also define the specific illness or injury for which the service is covered. One thing to be noted by employees of medical coding companies is that LCD dependent procedural codes are noted as such in the CPT manual and the guidelines have to be verified if the healthcare provider wants to submit such procedural codes.

The people in medical billing jobs should know that all the policy coverage documents related to the Centre for Medicare and Medicaid are held with the Medicare Coverage Database (MCD). It is required for professionals in medical billing jobs to know how to access NCDs and LCDs to identify and understand what is required for Medicare coverage of a certain procedure or service.

It is important for the professionals in RCM services to understand the various requirements of NCDs and LCDs to submit accurate claims for appropriate reimbursement for the services or procedures performed. Join Avontix one of the best RCM services providers in Hyderabad for the best experience in the field.

Comments

Popular posts from this blog

Hey Medical Transcriptionists, You’ll Love these Smart Online Resources

Who wouldn’t say they like a little extra help, be it at work or anywhere else?! Especially if you are a medical transcriptionist, you could be confused about a peculiar sounding word, the spelling of a doctor’s name that sounds funny, or maybe struggling with an unclear dictation where drug names sound French!We bring you five great sites to help you along the way. Just bookmark them for any-day reference! 1.      OneLook ( www.onelook.com ) You can quickly look up abbreviations, acronyms and medical words/phrases at this awesome online dictionary. It has amazing wildcard search options and other advanced search tools. Wildcard search means looking for a word in the dictionary that you cannot spell. You can check out the wildcards link at the end of the page to know how to use this option. The site’s features are a step ahead of other sites. You can look at the example searches on the homepage to know how yo

That’s Hilarious! Funny Must-Read Medical Transcription Errors!

Doctors every now and then come across some very critical bloopers from medical transcriptionists. Some of these can be downright funny! It’s common for transcription errors to creep in for various reasons like the dictation might not be clear, too many medical terms stuffed in, or misunderstanding at the transcriptionist’s end. Medical transcriptionists vary in experience and skill and may not be well versed with some medical terms. Here is a compilation of some very funny transcription mistakes you could note to avoid being on the receiving end of the laughter!     ·   " Eyes and nose continue to be within normal limits" (I & O).    ·     "History of sick as hell disease" (sickle cell)    ·     "She was a bitch and grinned " (a bit chagrined).    ·     "The last day the patient took their meds was for beaver ."  (forever).    ·     “49 year old occasional male” (Caucasian male).    ·     “Borderline respect

Software Trends that Impact Healthcare Industry -Avontix

Healthcare is an industry that has evolved a lot over years and is seeing a tremendous transformation in the manner the services are provided. This kind of transformation is a result of numerous innovative technologies that impact every aspect of the healthcare industry; especially the health information management and electronic health records. One of the key elements of these technologies is the use of software products in providing health and maintaining the healthcare information. The major benefit of these software products’ use is that both the care provided by facilities and the experiences of the patients will improve over some time in the coming years. Here are some software trends that are going to influence the way healthcare industry works. Patient portals : With almost everyone using information technology and the internet these days, patients are becoming more active in participating in their healthcare treatment. This tendency of patients showing interest i