decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 2303 / 2303
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Article Overview
This article covers a Medicare Carriers Manual policy topic related to services that do not meet the reasonable-and-necessary standard. It is useful for coders, billing staff, compliance teams, and reimbursement professionals who need to understand the general scope of this coverage guidance and how it fits within Medicare manual policy references.
Why This Topic Matters
It helps readers recognize a high-level Medicare coverage principle that can affect whether services are payable under the manual framework.
Article Sections
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Ed. Note: For further information see
A cross-reference to related coverage material in the manual and associated service categories.
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2303. Services not reasonable and necessary
A Medicare policy discussion of services that fall outside the reasonable-and-necessary standard for diagnosis, treatment, or functional improvement.
What You Will Learn
- The general Medicare coverage topic addressed by this manual section
- How the section frames the reasonable-and-necessary standard
- Where the article points readers for related manual guidance
- The type of service coverage issue discussed in the section
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Healthcare administrators
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