Effective August 12, Medicare is expanding its list of Healthcare Common Procedure Coding System (HCPCS) codes for prior authorization, face-to-face...
Read moreDetailsThere has been a long-standing requirement, by Medicare and many other payers, that any custom-fabricated item must be supported by...
Read moreDetailsThe profession is buzzing with talk of the proposed Medicare Lower Limb Prostheses (LLP) Local Coverage Determination (LCD). The last...
Read moreDetailsThere has been a long-standing struggle for patients diagnosed with lymphedema to receive Medicare and other payer coverage for compression...
Read moreDetailsThere is a common misconception in O&P that repair claims either aren’t paid at all or they aren’t paid adequately....
Read moreDetailsHave you heard the news? The Centers for Medicare & Medicaid Services (CMS) is cracking down on how Medicare Advantage...
Read moreDetailsIt’s not uncommon for an appeal to be denied or an audit to occur based on a technicality related to...
Read moreDetailsAlthough there are other codes and circumstances that warrant the use of narratives on a claim, not otherwise classified (NOC)...
Read moreDetails“The procedure or service is inconsistent with the patient’s history.” This is the message you’ll see on a Medicare Explanation...
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