DecisionHealth, DecisionHealth - 2021 Issue 12 (December)

New coverage guidance: Prepare for denials of MAC with ESI

The new uniform local coverage determination (LCD) for epidural steroid injections includes an almost complete ban on sedation and Monitored Anesthesia Care (MAC). Practices that bill for the sedation services should be prepared for denials, and that includes careful documentation and coding, new practice policies and discussions with patients who receive the injections which could include issuing ABNs.

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