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Any Procedure Not Listed On
Prepay Medicare Review Part B
Documentation Requirements Page
Medical Review has numerous procedure codes on special review. The procedure codes are reviewed based on Local Coverage Determination (LCD) and in some instances CMS Internet Online Manual (IOM) criteria. Review of any procedure code is to determine
that it meets coverage criteria.
There may be specific procedures that are reviewed by the Medical Review area which are not addressed in the list above. If you should receive a request for medical records and can not identify the specific reason for the review based on this list,
please submit medical records to support the services billed as identified by date and procedure code on the request. |
