General Surgery Coding Alert - 2009 Issue 31
STRATEGY: Beware of Buying Equipment Before Ensuring Medicare Reimbursement
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Article Overview
This article discusses the risks of relying on manufacturer claims when evaluating new medical equipment, devices, or injectable products for reimbursement. It emphasizes checking Medicare and other payer policies, confirming coding guidance with the appropriate carrier or MAC, and looking for coverage limitations or policy requirements before making a purchase. The piece is aimed at coding, billing, and practice management professionals who evaluate equipment investments and reimbursement viability.
Why This Topic Matters
Buying equipment without confirming coverage can lead to claim denials, unrecoverable costs, and compliance problems. The article matters because it highlights the need to verify payer policy and coding guidance before committing to technology purchases.
What You Will Learn
- Why manufacturer reimbursement claims should be verified with payers
- What kinds of payer coverage checks are important before purchasing new equipment
- How payer policies and medical necessity restrictions can affect reimbursement
- Why coding guidance for devices and products should be confirmed independently
- Why new technology reimbursement may differ across payers and regions
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Office managers
- Revenue cycle professionals
Codes Discussed
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