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Medical Necessity Compliance
CMS states that in FY2003 5.8% of submitted claims resulted in improper overpayments totaling more than $11.6 billion. A majority of these overpayments are the result of medically unnecessary testing and procedures and improper coding practices.
Every Medicare provider struggles to comply with Medical Necessity Policies such as National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).
CodeMap Has A Solution: CodeMap Data Files
CodeMap maintains the most comprehensive database of Medicare coverage policy concerning laboratory and pathology procedures. Our database contains accurate and up-to-date information from NCDs as well as LCDs, formerly known as LMRPs. All NCD information comes directly from CMS program memorandum, transmittals and other communications. All LCD information contained in our database is derived directly from Medicare Carrier bulletins, LCD advisory meetings, and oth....
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