What will the scope of the compliance program depend on?
What describes whether specific medical items services treatment procedures or technologies are considered medically necessary under Medicare?
The National Coverage DeterminationsNational Coverage DeterminationsA national coverage determination (NCD) is a United States nationwide determination of whether Medicare will pay for an item or service. ... In the absence of a NCD, an item or service is covered at the discretion of the Medicare contractors based on a local coverage determination (LCD).https://en.wikipedia.org › National_coverage_determinationNational coverage determination - Wikipedia Manual describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare.
Which is part of an effective coding compliance program?
THERE ARE MULTIPLE BENEFITS of an effective coding compliance program. ... Essential components include inpatient coding policies and procedures, inpatient coder continuing education, diagnosis related group (DRG) reconciliation, case-mix index (CMI) tracking, auditing and monitoring, corrective action, and annual updates.