tci Part B Insider - 2003 Issue 31

Local Medical Review Policies: MAC Ban for Cataract Surgery on Hold - for Now

 Prepare to battle more attempts to end 00142 coverageIf your practice performs cataract surgeries or provides anesthesia for them, you could have a fight on your hands. Last spring, Part B carrier Noridian came out with a new draft local medical review policy for monitored anesthesia care (MAC) in which Noridian said it would no longer cover MAC along with lens surgery (00142). Specifically, Noridian included that code on a list of codes that it would consider medically unnecessary with MAC. With MAC, an anesthesiologist must be continually present to monitor the patient's vital signs. After...

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