decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 12 (December)
You may not know it, but . . .
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Article Overview
This short article describes a CMS website feature for checking Medicare coverage information by pairing a procedure code with a diagnosis code. It is aimed at medical coders and billing staff who need to verify local coverage policy references and understand the general categories of results returned by the database.
Why This Topic Matters
Coverage verification affects whether a service is considered medically necessary under local Medicare policies. The article points readers to a CMS resource used to support coding and reimbursement research.
What You Will Learn
- How a CMS coverage database search is used at a high level
- What kinds of coverage result categories the tool returns
- How the article frames the relationship between procedure codes, diagnosis codes, and local coverage policy research
- Which types of users may benefit from checking Medicare coverage references
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Revenue cycle personnel
- Compliance staff
Codes Discussed
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