ICD10monitor April 17, 2024
Ronald Hirsch, MD, FACP, ACPA-C, CHCQM, CHRI

Our first topic today is local coverage determinations (LCDs) and variation. I have written in the past about national and local coverage determinations, and I have complained about how it is incomprehensible that the coverage for a procedure can vary among Medicare jurisdictions, with each Medicare Administrative Contractor (MAC) developing their own coverage determinations, including different indications and requirements. Crossing a state line should not change the ability to get medical care.

A physician advisor pointed out another nuance to this. His hospital had started doing MRI-guided focused ultrasound surgery for treatment of essential tremor. Now, while the procedure includes the word “surgery,” there is no incision or any device used that goes in the body. The patient is not...

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Topics: HIM (Health Inf Mgmt), Provider, RCM (Revenue Cycle Mgmt), Technology
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