After years of issues with cardiac pacemaker coverage, the dust has settled and reviews by the recovery audit contractors (RACs) are on the horizon. The RACs will review documentation to determine if cardiac pacemakers meet Medicare coverage criteria, applicable coding guidelines, and/or are medically reasonable and necessary. Recently, the Centers for Medicare & Medicaid Services (CMS) began allowing Medicare Administrative Contractors (MACs) the discretion to implement the National Coverage Determination (NCD) at the local level. Local coverage policies contain complex claims processing requirements that are causing claim denials and appeal challenges.
Join Jill Knight as she reviews the current state of pacemaker coverage, and how to set up a compliant documentation and coding program to secure appropriate payment and defend against forthcoming RAC audits.
During part one of this exclusive webcast, Jill Knight will…
- Help you understand the current state of CMS coverage for cardiac pacemakers
- Review the recently released RAC audit initiatives
- Review the local coverage claims processing requirements
- Discuss and analyze common causes of denials
- Provide you key documentation and coding tips to defend RAC audits