tci Medicare Compliance & Reimbursement - 2004 Issue 44

Hospitals: Don't Let Coverage Determinations Bury You

Bone up on the impact of regulatory changes.With the changes that recent Medicare legislation has made to what's covered and what's not, ignorance about the ins and outs of LMRPs, LCDs and NCDs can mean big reimbursement and compliance problems. Before you drop the next claim according to outdated rules, read this to figure out where to turn for updated information. Get to the Nitty-Gritty: LMRPs. In short, local coverage determinations (LCDs) are less specific than local medical review policies (LMRPs), and an LMRP can include one or more LCDs.  An LCD is a decision by a...

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