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U.S. Healthcare Crisis Turnaround?

U.S. A.

Drs. & Hospitals Employers

$1.0 Trillion / Year

$$$ ERISA $$$

50% Savings

The Only Company with Compliant Solutions for All of You

 

New Federal Health Claims & Appeals Laws & Regulations

for 193 Million Americans

Effective 09-23-2010

©2010, Jin Zhou, ERISAclaim.com

Photo of President Gerald R. Ford signing Employee Retirement Income Security Act of 1974

President Obama Signing Health Bill on 03/23/2010

President Gerald R. Ford Signing ERISA on 09/02/1974

New Webinars, Seminars & Certification Classes Announced for New Federal Health Claim Appeals Regulations on July 22, 2010 from HHS, DOL & IRS, Effective On Sept. 23, 2010 for 193 Million Americans

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UNITED STATES

DEPARTMENT OF LABOR

(Links to DOL) ©2010, Jin Zhou, ERISAclaim.com

Patient Protection and Affordable Care Act

Statutory Laws [PDF] [PDF]

 

 

Employee Retirement Income Security Act — ERISA

Webinars, Seminars & Certification Classes for New Federal Health Claim Appeals Regulations

 

ERISAclaim.com - Free Webinars - New Federal Claims & Appeals Regulations, Effective Sept. 23, 2010, for 193 Million Americans

 

ERISAclaim.com: Seminars - 2010 Two-day Basic ERISA Appeal Seminars - Denials and Overpayment Appeals

 

ERISAclaim.com - 2010 PPACA & ERISA Claim Specialist Certification Programs in Chicago, Illinois

 

ERISAclaim.com:  Create An Appeal Department for Your Hospital or Practice (In-house, onsite ERISA Claim Specialist Certification Programs)

 

ERISAclaim.com - 2010 Claim Denial & Overpayment Dispute Two-day ERISA Appeal Seminars,

 

ERISAclaim.com - 2010 ERISA Claim Specialist Certification Programs in Chicago, Illinois

 

New ERISA Appeal Book with 2010 Major Updates  $450  & $150 (Updates only with previous purchase)

 

ERISAclaim.com - ERISA Litigation Support, Facts + Laws + Strategies = Winning Lawsuit When Inevitable

 

ERISAclaim.com - Free ERISA Webinar, The Beginning for $6 Trillion Healthcare Denial Management Market

 

U.S. "Healthcare $1 Trillion Crisis"

You Are The Bailout Plan

 

© JIN ZHOU, President,

ERISAclaim.com

Dec. 09, 2008

 

"U.S. healthcare crisis is bigger than any other industries in need of urgent bailout plan, but healthcare industry will never go to Congress asking for a $1 trillion bailout plan, as Congress can't afford to bailout healthcare $53 trillion crisis.

 

The U.S. healthcare industry has been doing its bailout plan in an extremely unique way: YOU ARE THE BAILOUT PLAN!

 

The healthcare Industry employed the same scheme as other industries have done, healthcare foreclosures and healthcare repo's:

 

"OVERPAYMENT RECOUP = MEDICAL FORECLOSURES AND REPO'S"!

 

Coupled with no pays, late pays and low pays, the healthcare industry has been quietly but successfully bailing itself out from the worst U.S. economic recession and healthcare recession since WWII.

 

Healthcare providers, as the largest share of healthcare  bailout, consumers and employers are all suffering from this quiet but detrimental economic medical haemorrhage.

 

Dr. Jin Zhou, president of ERISAclaim.com in Illinois, shares his unique insight and possible practical solutions for every one.

 

 

 
 

 

Ability to Pay < Liability to Pay =

U.S. $1 trillion Healthcare Bubble  in 2009

 

$53 trillion in government debts and liabilities

 

"The long-term economic health of the United States is threatened by $53 trillion in government debts and liabilities that start to come due in four years when baby boomers begin to retire. (Related graphic: U.S. economy threatened by aging of America)
 
 
 
                 Health Care Recession is Here
                
Provider SVU = Special Victim Unit
 
 
Insurance Pay Is Down+Patient Pay Is Down = $7.5T+$14T

 

Insurance Wanted $$$ Back from You =  ERISA SIU (Private Sector)

 

Medicare Wanted $$$ Back from You=MSPRC & RAC (Public Sector)

 

You Are the Healthcare Bailout Plan=$1 trillion <Overpayment Refund

 

Healthcare SVU= Healthcare Special Victim Unit.

 

Medicare RAC + MSPRC = $1B (3  states) x 10 states = $10B, 50 states?

 

ERISA SIU =  Special Investigation Unit, aka, “Overpayment” Dept.

 

Provider SVU = Special Victim Unit=No Pay, Low/Late Pay + Payback

 

Medicare RAC + ERISA SIU = Provider SVU = $1 trillion Bailout Plan.
 
How To Survie From $1 Trillion Healthcare Recession???
 
 
 
“This bulletin presents findings of the 2005 National Compensation Survey (NCS) regarding detailed provisions of healthcare and retirement plans in private industry conducted by the U.S. Bureau of Labor Statistics (BLS).”
 
Both the percentage and the number of people without health insurance increased in 2006. The percentage without health insurance increased from 15.3 percent in 2005 to 15.8 percent in 2006, and the number of uninsured increased from 44.8 million to 47.0 million.

 

The number of people with health insurance increased to 249.8 million in 2006 (up from 249.0 million in 2005). In 2006, the number of people covered by private health insurance (201.7 million) and the number of people covered by government health insurance (80.3 million) were not statistically different from 2005.
 
The percentage of people covered by employment-based health insurance decreased to 59.7 percent in 2006, from 60.2 percent in 2005.

 

The percentage of people covered by government health programs decreased to 27.0 percent in 2006, from 27.3 percent in 2005. The percentage and the number of people covered by Medicaid were statistically unchanged at 12.9 percent and 38.3 million, respectively, in 2006.

 

Most people (59.7 percent) were covered by a health insurance plan related to employment for some or all of 2006, a proportion that was statistically lower than that of 2005. The rate of private coverage decreased in 2006 to 67.9 percent, from 68.5 percent in 2005, while the number of people covered by private insurance was statistically unchanged at 201.7 million in 2006"
 

Specific Solutions

from Jin Zhou

 

ERISA=$$$, PPO=Discount

 

ERISA & SPD control coverage and medical necessity, ultimately control benefits money payment;

 

While MCO contract control provider discount

 

MCO contract is a third-party discount instrument while ERISA & SPD control benefits entitlement and applicable rights under the plan.

 

Hospital   CEO’s, CFO’s, COO’s, Senior Executive And Management Teams Must Be Educated On ERISA And Medicare Claim Regulation And ERISA Impact On Hospitals Bottom Line.
 
Hospitals And Healthcare Facilities Must Have Executive Crisis Turnaround Strategies To Lead And Guide The War On Reimbursement Crisis.
 
 
Hospitals And Healthcare Facilities Must Establish Special Appeals Department, Beyond And Above Traditional Coding And Billing, With Highly And Specially Trained Specialists & Experts To Manage Reimbursement Crisis Through Compliance And Risk Management – Special Appeals Department (SAD)
 
Reimbursement Nowadays = 30% Coding/Billing/MCO Contracting + 70% Claims Regulations
 
Hospitals And Healthcare Facilities Must Train, Educate Or Hire ERISA Claims Specialists (ECS) And Medicare Claim Specialists (MCS) To Staff Special Appeals Department (SAD)

 

Two Step Process To Initiate This Practice With Three-day Training Programs, Then Perfect This Renovation With 12-day ERISA & Medicare Claims Specialists Certification Programs To Make Your Own Certified Specialists
V: MANAGED CARE CONTRACTING MUST BE IN COMPLIANCE WITH ERISA, OR OTHERWISE FINANCIAL SUICIDAL CONTRACTING.

 

 Medicare Claim Specialists, With Dual Knowledge & Expertise

V.

Medicare Claims Specialist Must Have Dual Knowledge And Expertise, Similar To The Requirements For Medicare Second Level Appeal (Reconsideration) Panel Members (QIC’s)

 

Dual Knowledge & Expertise = Coding & Billing + Medicare Claim Regulation + Sufficient Medicolegal + Appeal Strategy

 

Qualifications Of The QIC's Panel Members. (1) Members Of A QIC's Panel Who Conduct Reconsiderations Must Have Sufficient Medical, Legal, And Other Expertise,including Knowledge Of The Medicare Program.” 70 Fr 11472 § 405.968 (C)
 
You are the bailout plan by default, regardless if you see it or like it.

 

Billing and coding have nothing to do with this crisis turnaround

 

Documentation quality has nothing to do with this crisis turnaround

 

Fraud and abuse Prevention has nothing to do with this crisis turnaround

 

Managed care contracting has nothing to do with this crisis turnaround

 

It is about jungle survival when everyone is at bankruptcy doorsteps when we are all in a nightmare of at least $1 trillion short.

 

ERISA and Medicare compliant strategies and appeals are the only way to survive in this economic crisis.

 
Dr. Jin Zhou will show you how to survive from this healthcare recession with $1 trillion healthcare bubble.

 

Jin Zhou

President

www.ERISAclaim.com

630-736-2974 (Office)

630-808-7237 (Mobile)

 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

Statutes (United States Code) 
ERISA - Title 29, Chapter 18. 

        Selected links:

Sec. 1002.
Definitions

Sec. 1003.
Coverage

Sec. 1022.
Summary plan description
Sec. 1104.
Fiduciary duties

Sec. 1140.
Interference with protected rights

Sec. 1141.
Coercive interference

part 7
group health plan requirements

 

 

Code of Federal Regulations

Codified in Title 29 of the Code of Federal Regulations:

Regulations

        Selected links:

2520.102-3 Contents of summary plan description.
2560.503-1 

Claims procedure.

 

 

ERISA Laws/Rules

ERISA in the United States Code: Cross-reference table, table of contents

 

 

ERISA Not Insurance
 

Aetna Video Shows ERISA Patients Mistreated

 

"According to the video, when faced with claims for identical medical problems, Aetna separates the claims where no damages are available - those subject to the federal Employee Retirement Income Security Act, or ERISA - from non-ERISA claims, where consumers can sue.1 2"

 

Aetna ERISA Settlemnt with 950,000 MD's

 

Department of Labor

 
"A group health plan is an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.

Most private sector health plans are covered by the

 Employee Retirement Income Security Act (ERISA). Among other things, ERISA provides protections for participants and beneficiaries in employee benefit plans (participant rights), including providing access to plan information. Also, those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct under the fiduciary responsibilities specified in the law."

 

 

AMNews through  AMA

Health plans subject to new federal appeals rules
Much-postponed regulations offer patients and doctors fairer and faster review, plus new rights, Dept. of Labor says.

 

 

 

 

 

 

View CMS Chart Series

 

CMS Facts & Figures

 

CMS offers various Chart Series with recent data on spending, operations, and quality of care in CMS programs. The Chart Series also offer some information on the nation´s health care system, and CMS internal operations.

 

Each of the sections covers a different topic, and is available to view or download as a PowerPoint presentation (.ppt file, recommended) or in Adobe Acrobat (.pdf) format.

 

 

HHS Press Release:
 

2004.02.19: Text of Letter From Tommy G. Thompson Secretary of Health and Human Services To Richard J. Davidson, President, American Hospital Association.  

HHS FAQ "Questions On Charges For The Uninsured" (PDF)

HHS FAQ's "regarding offering discounts to the uninsured" (PDF)

 

OIG "HOSPITAL DISCOUNTS OFFERED TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR HOSPITAL BILLS"


National Correct Coding Initiative Edits - Version 11
 

National Correct Coding Edits for the Hospital Outpatient PPS - Version 10.3


2003 Improper Medicare Fee-for-Service Payments Report

 

CMS Announces Revisions to Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004

 

Medicare Announces 2004 Physician Fee Schedule and Payment Policy Changes

CMS Files for Download for Medicare Payment Systems

 

CMS Finalizes Appeals Process for Medicare Coverage Decisions

 

2003.12.10: HHS Announces Immediate Steps to Make Medicare-Approved Drug Discount Card Programs Available Next Spring

 

42 CFR Parts 403 and 408
Medicare Program; Medicare Prescription
Drug Discount Card; Interim Rule and Notice (pdf) (89 pages)

 

Revision of Billing Instructions for Purchased Services
 

Regional Offices Link


WPS Medicare Part B - 2005 Medicare Payment Information Available from CD-Rom

 

 

 

 

 

 

CERT  Reports

Improper Medicare Fee-For-Service Payments Report and Update Archive

 

2004 Improper Medicare Fee-For-Service Payments Report

 

Short Report (859 KB)

 

Long Report (1.04 MB)
Long Report Appendix (2.29 MB)

 

First Update Report (356 KB)

 

Second Update Report(369 KB)

 

2003 Improper Medicare Fee-For-Service Payments Report

 

Short Report

(923 KB)

 

Long Report

(2.29 MB)

 

Medlearn Matters Provider Education

Coding and Reimbursement for Consultations in Medicare

03/25/2005

 

Unprocessable Unassigned Form CMS-1500 Claims
03/21/2005

 

DEMONSTRATION TO WORK TOWARD ASSURING ACCURATE MEDICARE PAYMENTS

March 28, 2005

"TESTS ABILITY OF RECOVERY AUDIT CONTRACTORS TO TRACK OVER AND UNDER PAYMENTS"

 

What Physicians and Other Suppliers Should Know About Medicare Overpayments - A two sided tri-fold brochure (August 2004) (PDF format 19Mb)

 

CMS: Notice of New Interest Rate for Medicare Overpayments and Underpayments (R63FM) IMPL DATE: 2/8/2005

 

CMS: Revision to the Beneficiary Notification Process when Recovery is Sought from the Provider (R70FM) IMPL Date: 6/27/2005

 

New Remittance Advice (RA) Message for Referred Clinical Diagnostic / Purchased Diagnostic Service Duplicate Claims (R571CP )

 

Breaking News:  Employer Must Reimburse Medicare Over Payments under MSP

 

Telecare Corp. v. Leavitt

(Fed. Cir. 2005)

 

 

 

 

CMS Carriers Manual

Carriers Manual-Part 3

 

Chiropractic Services

 

2250. CHIROPRACTIC SERVICES - GENERAL
2251. COVERAGE OF CHIROPRACTIC SERVICES
2251.1 Manual Manipulation
2251.2 Utilization Guidelines
2251.3 Necessity for Treatment
2251.4 Location of Subluxation
2251.5 Treatment Guidelines

 

Outpatient Physical Therapy and Speech Pathology Services

 

2206. CONDITIONS FOR COVERAGE OF OUTPATIENT PHYSICAL THERAPY OR SPEECH PATHOLOGY SERVICES
2206.1 Physician’s Certification and Recertification
2206.2 Outpatient Must be Under Care of Physician
2206.3 Outpatient Physical Therapy or Speech Pathology Services Furnished Under Plan
2206.4 Requirement That Services Be Furnished on an Outpatient Basis

 

2207. CODING PHYSICIAN SPECIALTY
2207.1 Coding Type of Supplier and Nonphysician Provider
2210. PAYABLE PHYSICAL THERAPY (PT)
2210.1 Restorative Therapy
2210.2 Maintenance Programs
2210.3 Application of Guidelines

 

[PDF] CR3016: CMS Manual System
... CHANGE REQUEST 3016 I. SUMMARY OF CHANGES: Dentists, podiatrists, and optometrists
are added to the definition/list of physicians who may opt out of Medicare. ...

 

MM3016    MMA-Private Contract Manual Change to include Dentists, Podiatrists, and Optometrists in the Definition/List of Physicians Who Can Opt Out of Medicare

 

New Chiro Demo

Expansion of Coverage of Chiropractic Services Demonstration (CMS)

Special Alert:
(as of 9/19/05)

Provision of Physical Therapy Services Incident to a Chiropractor

April 06, 2005 -

MEDICARE IMPLEMENTS DEMONSTRATION TO EXPAND COVERAGE OF CHIROPRACTIC SERVICES

 

MEDICARE CHIROPRACTIC SERVICES DEMONSTRATION
FINAL DESIGN REPORT,

Click here. (pdf. 532kb)

April 27, 2005

 

  1. Federal Register Notice (.pdf 57 kb)
  2. Press Release (.pdf 58 kb)
  3. Chiropractor Medlearn Matters Article
  4. Laboratory Medlearn Matters Article
  5. Radiology Medlearn Matters Article
  6. Chiropractor Power Point Presentation (.pdf 177 kb)
  7. Beneficiary Fact Sheets

  1. Demonstration Geographic Areas
  1. Diagnosis and Procedure Codes (.pdf 135 kb)
  2. Frequently Asked Questions and Answers (pdf. 18kb)

 

05/06/2005

INSTRUCTIONS RELEASED -- MID-QUARTER

Transmittal 34 ... This instruction affects Comprehensive Outpatient Rehabilitation Facilities, Outpatient Physical Therapy, Skilled Nursing Facilities, Physicians and Non-Physician Practitioners.
View the complete text of Transmittal 34
(PDF - 366 KB)

 

MM3648 (Revisions to the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15, Sections 220 and 230 Regarding Therapy Services)

 

SE0533 (Further Clarification of CR3648, Which Revised the Medicare Benefit Policy Manual (Pub 100-02), Chapter 15, Regarding Therapy Services)

 

National Correct Coding Policy Manual for Part B Medicare Carriers -- Version 10.3

 

"O. Chiropractic Manipulative Treatment" [page 14 of 18]

 

United States of America v. Thomas Bruce Vest,
also known as T. Bruce Vest, doing business as Doctors Clinic

"Second, the Government presented 36 patients who testified that during their visits to the Doctors Clinic, they did not report many of the symptoms and past conditions that Vest recorded on their medical records."

Fraud And Abuse

Fighting Fraud & Abuse

 

MM3449 Revised Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy, Full Replacement of CR 3063 Revised: 11/19/2004

 

CR3449 (10/08/2004)

 

CMS Documentation Guidelines — Evaluation and Management Services

 

R125PI    CR4022

"Medical Review Additional Documentation Requests"

 

R123PI - CR3703

9/23/2005

 

"Chapter 3, MMA Section 935

I. SUMMARY OF CHANGES: This change implements portions of Section 935 of the MMA (entitled Recovery of Overpayments). Specifically, this CR explains to contractors their right to request documentation for a limited sample of submitted claims, after overpayments have been identified,"

 

CMS 2004 Transmittals 90-CR3569: Prepayment Review of Claims for MR Purposes (pdf)

 

"Contractors shall not initiate non-random prepayment medical review of a provider or supplier based on the initial identification by that provider or supplier of an improper billing practice unless there is a likelihood of a sustained or high level of payment error."

 

CMS 2005

Transmittal 120 --

CHANGE REQUEST 3880

"Correction to Change Request (CR) 3222: Local Medical Review Policy/ Local Coverage Determination Medicare Summary Notice (MSN) Message Revision"

"E. Distinguishing Between Benefit Category, Statutory Exclusion and Reasonable and Necessary Denials"

 

R13SOM: Revisions to Chapter 2, "The Certification Process," Appendix E-- "Providers of Outpatient Physical Therapy or Outpatient Speech Language Pathology (OPT/OSP) Services," and Appendix K-- "Comprehensive Outpatient Rehabilitation Facilities"

 

Medicare Program Integrity Manual

 

Chapter 3: Verifying Potential Errors and Taking Corrective Actions (pdf) (Zipped Word File)

 

 

Medical Review Strategy

 

"In addition to carry-over of several of the FY 2004 focuses, the new FY 2005 focus areas will be:

  • Chiropractic services
  • Level of consultations
  • Follow-up consultations

 

Transmittal 34

 

General Coverage of Physician Services***NCP

PHYS-001

 

Physician Visits, Documentation and Interpretation of Test Results***NCP

PHYS-002

 

Incident To a Physician's Professional Service in the Office or Clinic***NCP

PHYS-004

 

Outpatient Physical Therapy, Occupational Therapy and Speech-Language Pathology

PHYSMED-001

 

Coding Guidelines:
"...7. *The date the patient was last seen and the UPIN of the attending physician must be listed in Item 19 on the CMS-1500 form or the electronic equivalent."

 

Physical Medicine and Rehabilitation Procedures and Modalities

PHYSMED-009

 

Neuromuscular Electrical Stimulation (NMES)

PHYSMED-011

 

Illinois WPS Medicare Part B - Provider Education - Claim Information

 

Seminar Schedule

"WPS is frequently asked if we offer Continuing Education Units (CEUs) for our programs. We are happy to announce that......"

 

Seminar Materials

 

 

CMS (HCFA) 1500 Claim Form Instructions (pdf - 72 pages; 695KB)

 

Timely Filing of Claims

 

Unprocessable Claim Guidelines

 

How to Appeal a Claim Determination

 

 

Chiropractic Care Educational Guidebook (pdf - 95 pages; 476KB)

 - Jan. 2005

 

WPS Medicare Part B - Chiropractic FAQs

 

WPS Medicare Part B - 2005 Medicare Payment Information Available from CD-Rom

 

 

Medicare Part B WPS Search on "chiropractic care" 

 

Teleconferences

 

 

WPS Communiqué

 

Virginia TrailBlazer Part BHome Page

 

1500 Claim Form/Unprocessable Claim Form Instructions

 

Top 10 Billing Errors

 

General Principles of Documenting Patient's Medical Records

 

Provider Outreach and Education (Educational issues)

 

Audio Training

Chiropractic Services

 

CMS 1500 Claim Form Instructions

 

Part B Problem Solving Guide Adobe PDF or the TrailBlazer Medicare Part B Mid - Atlantic Important Contacts Adobe PDF.

 

Iowa Noridian Medicare: Provider Homepage

 

Noridian Medicare: Provider: Publications: Medicare B: Medical Policies

 

Chiropractic Services Policy

 

Chiropractic BBM July 2003

 

Chiropractic Care

 

Documentation

 

Diagnosis Criteria

 

x-ray

 

Advanced Beneficiary Notice

 

Questions and Answers

 

Chiropractic Demonstration Project

 

Appeals

Recoupment

EDI

Education

 

Telephone Appeals Changing Hours

5/11/2005

 

Medicare Part B Appeal

 

Documentation

 

Fraud and Abuse

 

Medicare Part B: Medicare Chiropractic Billing

Medicare Part B Workshop
 

Medicare B News Bulletins and LMRPs-LCDs(1994 to Current)     

 

 

NM Welcome To Arkansas Medicare Services

 

Fee Schedules

 

How to Complete the CMS-1500 Form

 

Helpful Hints for Filing Claims

 

Maine National Heritage Insurance Company

 

National Heritage Insurance Company is the Medicare Part B contractor for California, Maine, Massachusetts, New Hampshire, and Vermont, serving 5.5 million beneficiaries and 178,000 healthcare providers.

 

Physical Therapy Documention Books

Writing Soap Notes: With Patient/Client Management Formats by Ginge Kettenback, Ginge, MS, Pt Kettenbach (Paperback)

 

CMS Contractors

Medicare Provider Customer Service - Learning Resources

 

Claims Processing Manual Table of Contents

 

Medlearn Quick Reference Guides

 

Documentation Guidelines — Evaluation and Management Services

 

Medicare Learning Network - Coding Educational Resource Web Guide

 

ICD-9-CM Official Coding Guidelines

ICD-9-CM Official Guidelines for Coding and Reporting
Effective April 1, 2005 Narrative changes appear in bold text The guidelines have been updated to include the V Code Table

 

ICD-9-CM Conversion Table

 

Effective October 1, 2004

 

 

Other Coding Resources:

 

 

Training Materials & Courses

 

Fraud And Abuse

Fighting Fraud & Abuse

Fraud Schemes and Related Information

United States of America v. Thomas Bruce Vest,
also known as T. Bruce Vest, doing business as Doctors Clinic

"Second, the Government presented 36 patients who testified that during their visits to the Doctors Clinic, they did not report many of the symptoms and past conditions that Vest recorded on their medical records."

Contractor Instructions

 

Medical Review

"Most medical review doesn't require medical records"

 

MR Home

PI Manual

LMRP

Tech. Asst.

Links

CMNs

 

National Correct Coding Initiative (NCCI)

 

[PDF] MODIFIER -59 ARTICLE:

Proper Usage Regarding Distinct Procedural Service

 

 

HOPPS CCI EDITS

 

Physicians CCI EDITS

 
NCCI Policy Manual for Part B Medicare Carriers
Medicare Claims Processing Manual (Sec. 20.9)
NCCI FAQs
NCCI Edits Program Transmittals

   
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