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Find information on local and national coverage determinations specific to preventive services.
Do you find it challenging to identify a Medicare coverage policy concerning a particular item or service? Not sure what to do if a Medicare coverage policy doesn’t exist? A new FastTrack to Medicare Coverage Policies tool is now available…
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
To ensure that our site meets the needs of providers, we carefully analyze feedback and implement changes to improve customer satisfaction.
View these recommendations for the best website experience.
Here is a list of billing links to help increase billing accuracy as well as links to other Medicare program-related resources.
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and reminders related to the PAR.
Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly for cosmetic reasons. Functional or reconstructive eyelid surgery is performed to improve abnormal function, re…
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14-byte unique tracking number (UTN) number…