Medical policy

In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.

Read this article for helpful information to report the national drug code on claims.

Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…

Previous instructions to bill Rebyota fecal microbiota, live-jslm with HCPCS G0455, expired effective June 30, 2023. Instead, providers shall bill HCPCS code J1440 on the same claim with HCPCS 0780T…

First Coast identified several errors when providers bill for genetic testing. Read this article to learn more about billing these services correctly.

Clinical trials background What regulatory guidance addresses devices and clinical trials in the Medicare program? 

Clinical trials background What regulatory guidance addresses devices and clinical trials in the Medicare program? 

Medicare covers the routine costs of qualifying clinical trials, as such costs are defined in National Coverage Determination (NCD) 310.1, as well as reasonable and necessary items and services used…

Medicare covers the routine costs of qualifying clinical trials, as such costs are defined in National Coverage Determination (NCD) 310.1, as well as reasonable and necessary items and services used…

Visit our Journey to LCD coverage page to find more information related to LCDs, including the LCD development process and how to become involved, as well as how local and national coverage…