local medical review policy
Download
Skip this Video
Download Presentation
Local Medical Review Policy

Loading in 2 Seconds...

play fullscreen
1 / 12

Local Medical Review Policy - PowerPoint PPT Presentation


  • 611 Views
  • Uploaded on

Local Medical Review Policy. Presented by: Susan Magdall, CPC, CHC Institutional Compliance Program. Local Medical Review Policy. Also known as LMRP Used to assist providers, physicians, and suppliers in submitting correct claims for payment. Local Policies.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Local Medical Review Policy' - Leo


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
local medical review policy

Local Medical Review Policy

Presented by:

Susan Magdall, CPC, CHC

Institutional Compliance Program

local medical review policy2
Local Medical Review Policy
  • Also known as LMRP
  • Used to assist providers, physicians,

and suppliers in submitting correct claims for payment

local policies
Local Policies
  • Outline how contractors will review claims
  • Must be consistent with national guidance
  • Are developed by contractor medical directors
lmrp medical necessity
LMRP - Medical Necessity
  • Diagnosis driven
  • Diagnosis must be covered under LMRP
national coverage decisions
National Coverage Decisions
  • National medical review policy - Labs
non covered services
Non - Covered Services
  • Non Covered
  • Annual Check-up
  • Cosmetic Plastic

Surgery

  • Services never covered by Medicare
abn advanced beneficiary notice
ABN -Advanced Beneficiary Notice

The patient must be notified if a service

being provided might not be covered by

Medicare and sign the ABN

lmrp website
LMRP Website

http://www.lmrp.net/

lmrp trailblazer website
LMRP Trailblazer Website

http://www.the-medicare.com/

LMRP

CPT 45380

DX 211.3

national coverage decisions website
National Coverage DecisionsWebsite

http://www.hcfa.gov/medicare/mr/lmrp.htm

national coverage decisions website11
National Coverage DecisionsWebsite

http://www.hcfa.gov/coverage/default.htm

advanced beneficiary notice website
Advanced Beneficiary Notice Website

http://www.hcfa.gov/medlearn/faqabns.htm

ad