decisionhealth Newsletters, Coder Pink Sheets - 2003 Issue 10 (October)
Pacemaker checks by reps
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Article Overview
This article examines a Medicare billing compliance question involving pacemaker and ICD checks performed by manufacturer representatives, including discussion of whether a practice can bill for services performed by non-employees or leased personnel. It is aimed at coding professionals, physicians, practice managers, and compliance staff who need to understand the broad legal and reimbursement concerns raised by these arrangements. The article also references guidance from Medicare and professional society perspectives on reporting the professional component versus the global service.
Why This Topic Matters
Billing for device checks affects reimbursement, supervision, and compliance exposure. Understanding the boundaries discussed in the article helps practices evaluate risk when outside personnel are involved in device analysis services.
What You Will Learn
- How Medicare-related billing concerns arise when device checks are performed by manufacturer representatives.
- Why leased personnel arrangements for these services are discussed from a compliance perspective.
- How professional and organizational viewpoints differ on reporting device check services.
- What broad legal and reimbursement issues are associated with these arrangements.
Who Should Read This
- Medical coders
- Compliance professionals
- Physician practice managers
- Cardiology practices
- Electrophysiology staff
- Health care attorneys
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