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.
Post a Comment

Popular posts from this blog

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 respectable pancreatic cancer”. (Resectable).    ·“Patient is alert and orien…

Location isn’t a Matter for Coding and RCM -Avontix

The technological developments in the healthcare management industry have facilitated and increased the outsourcing of medical coding and RCM among many healthcare facilities. The healthcare facilities need not bother about from where the support for their RCM and medical coding jobs is coming from. What they need to think about is only if these service providers have the latest technology, training and subject expertise. These days most of the outsourcing companies are well equipped with high-speed internet connectivity, coding and RCM software with security features that make the importance of the location of the service provider negligible.
The lower reimbursement rates and diminishing margins are forcing the different healthcare facilities to think for ways to reduce costs. One of the best ways for hospitals and other facilities to minimize costs is outsourcing their medical coding jobs along with their revenue cycle management. The significant task for a hospital is to identify …

Healthcare Documentation – A Promising Career Option -Avontix

Picture courtesy: explorehealthcareers.org
With ever-changing legal and medical requirements, it is mandatory that all the procedures and processes performed by healthcare practitioners are recorded accurately not just for evidential purposes but for future references also. However, it is not possible for the physicians, nurses, and other healthcare professionals to keep documenting each and every process performed by them in a written format. Hence, physicians take advantage of the technological advancements and record the procedures performed by them in audio files using an electronic device. Although these can serve as records, it is not easy to comprehend a physician’s voice file when the information is required. So, these voice files are transcribed into electronic documents and this process of transcribing is called medical transcription or healthcare documentation.  
The voice files given by the physicians for healthcare documentation include their office visits, emergency room …