Oct 18, 2015 | Medical billing basics
• Therapeutic procedures are procedures that attempt to reduce impairment and improve function through the application of clinical skills and/or services. • Use of these procedures requires that the practitioner have direct...
Oct 13, 2015 | Medical billing basics
MCO Excluded Services (Fee-For-Service) The MCO’s are responsible for providing all Medicaid covered services excluding the following, which are paid fee-for-service by Medicaid: Abortion Services – MCO’s are responsible for related services performed as part of a...
Oct 6, 2015 | Medical billing basics
The following clinical guidelines pertain to the specific modalities listed. G0283 – This modality includes the following types of electrical stimulation: • Transcutaneous Electrical Nerve Stimulation (TENS). • Microamperage...
Oct 1, 2015 | Medical billing basics
Payments to Managed Care Organizations Recipients are linked by their MCO to a primary care physician or clinic. All MCO-enrolled recipients are provided an identification card by their respective MCO. As a result, recipients must obtain all services except services...
Sep 24, 2015 | Medical billing basics
For claims submitted by a physician or NPP: • Services performed by non-employees or those not under a physician’s or NPP’s direct supervision are not covered. • Services not relating to a written treatment plan are not medically...
Sep 15, 2015 | Medical billing basics
Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Notice: It is not appropriate to bill Medicare for services that are not covered (as described by this entire LCD) as if they are covered. When billing for non-covered services, use the...
