medicare guidelines

  1. G

    Wiki Third level facets with Medicare

    Anyone know what would be considered "Unique Circumstances" that would qualify Medicare paying the third level facet diagnostic injections and the RF injections since the new LCD is not considering them Medically Necessary now?
  2. KStaten

    Wiki What Designates an "Active Involvement" in Plan of Care?

    Hello Everyone! 🙂 According to what I have read (in regards to incident-to billing), in order for a patient to be seen by the PA and still be billed under the doctor, the doctor must do the following: 1) Initiate the treatment 2) Continue to be "actively involved" in the patient's case/ plan...
    • KStaten
    • Thread
    • active treatment actively involved documentation frequency incident to billing medicare guidelines phycisian's assistant physician plan of care time
    • Replies: 2
    • Forum: Medicare Regulations
  3. KStaten

    Wiki Who Has Documentation Permissions per Medicare Guidelines?

    Hello Everyone! :) I am trying to put a table together to describe components of a medical document for a typical outpatient setting office visit and list who (per Medicare guidelines) has permission to document each one. In other words, in order to correctly bill under the physician, what...
    • KStaten
    • Thread
    • ancillary staff documentation e/m documentation established patient hpi incident to billing medical record medicare guidelines new patient phycisian's assistant
    • Replies: 6
    • Forum: Medicare Regulations
  4. K

    Wiki Pharmacist Options - CHC

    I work for an FQHC/CHC and they are trying to catch missed revenue. I know a Pharmacist only encounter is 99211 (nonbillable in our setting). However, if they implement a process where the Pharmacist initiates the visit like a RN would and then leaves the MDM to the provider for completion...
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