2024 Medicare Coverage: Medicare’s NCD, LCD and the Relative Value File
Course Description:
Are you responsible for looking up whether a service is covered in the Medicare program at your facility? Are you confused about where you should be looking to find the information you need to make this determination? If you ever had claims denied due to a local coverage determination (LCD) or a national coverage determination (NCD), you definitely should attend this webinar. You can avoid these costly and sometimes unnecessary claim denials! Expert Lynn M. Anderanin will review the National Government Services Medical Policy Center and the Medicare Coverage Database on the CMS website to assist you with finding the resources you should be familiar with.
The Medicare Carrier system is divided into geographical areas in which different carriers are contracted to adjudicate claims for Medicare Part A and B patients. NCD are National Coverage Determinations that give direction on billing and coding for certain procedures that apply to all providers in any geographical area. There is also a spreadsheet which for each NCD that describes the payable ICD-10-CM codes for the procedures in the policy, if applicable, along with other information needed for correct claims submission. In the absence of a NCD, a Local Coverage Determination, or LCD, may be created by a particular Medicare carrier for Part A or B benefits on a particular or group of procedures and/or services. The NCD would only apply to those states that are listed on the NCD, and cannot be applied claims for other jurisdictions. This can complicate things as one state may cover a service or procedure for a particular reason, but the next state may not. This webinar will show attendees how to locate the appropriate NCD and LCD for their area, and give direction on how to use the information in the policies.
Learning Objectives:
- Know the latest Medicare rules and guideline for NCD and LCD
- Learn how to apply the Medicare’s coverage determinations and relative value file in either the original claims billing and coding
- When a claim has been denied how to apply the information to their claim to obtain proper reimbursement
- Learn how to Navigate through the Medicare Website for NCD
- Looking up LCD for your geographical location
- Know how to search for the information you need
- Review the parts of the Medicare LCD or NCD
- Choosing pertinent articles related to LCD
Areas Covered in the Session:
- 2024 Medicare Coverage Rules and Requirements
- Locating NCD on the Center for Medicare and Medicaid Services (CMS) website
- Utilize the information on the NCD spreadsheet to determine coverage for medical necessity
- How to receive information when policies are updated
- Look up LCD for your state
- Dissect an LCD explaining the different pieces of information
- Discovering LCD articles that give further detailed instructions on application of an LCD
- Apply the Medicare’s coverage determinations and relative value file in either the original claims billing and coding
- Analyze the information found in the Relative Value File
- Apply the Relative Value File to coding and claims processing
- Live Q&A Session
Suggested Attendees:
- Healthcare Executives CEOs, COOs, CFOs
- Healthcare Providers
- Medical Billers and Coders
- Medical Assistants
- Claims Processors
- Collectors and Payment Posters
- Hospital and Facility Administration
- Healthcare Policy Analysts
- Healthcare Business Researchers
- Legislative or Regulatory Advisors
- Practice Managers
- Supervisors
- Physician and Non-Physician Providers
- Qualified Healthcare Professionals
- Compliance officers
- Consultants
- Claims Adjusters
- Anyone Involved with Professional Fee for Service Billing and Coding
About the Presenter:
Lynn M. Anderanin, CPC, CPB, CPMA, CPC-I, CPPM, COSC, is the Sr. Coding Educator for Healthcare Information Services, a revenue cycle management and consulting service in the Chicagoland area. Prior to relocating to Chicago, Lynn was the Billing Office Manager and surgical coder for Hand Surgery Associates, now Michigan Surgery Specialists in the Detroit Area. She has over 39 years of experience in all areas of the physician practice including Practice Administrator, Billing Manager, and Director of Operations. Her experience is primarily in the specialties of Orthopaedics, Rheumatology, and Hematology/Oncology. She has been a speaker for many conferences, including the AAPC National Conferences and Workshops, Community Colleges, Audio Conferences, Certification classes, and Webinars. Lynn became a CPC in 1993, a Certified Instructor in 2002, and a Certified Orthopedic Surgery Coder in 2009, an examination in which she participated in creating. She passed the Certified Practice Manager exam in 2015, the Certified Medical Auditor exam in 2016, and the Certified Professional Biller exam in 2021. Lynn is the founder of the first local chapter of the AAPC in Chicago, which is now 25 years old, and a former member of the AAPC National Advisory Board as well as several other committees for the AAPC.
Additional Information:
After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to talk and hear clearly
Can’t Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
Snippet From Our Previous Session:
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- 2024 Medicare and Commercial Plans and Coverage Changes
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Testimonials:
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Tina Duffy, Compliance Officer