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To sign up for updates or to access your subscriber preferences, please enter your contact information below. %%EOF endobj Quantification assays of HIV plasma RNA are used prognostically to assess relative risk for disease progression and predict time to death, as well as to assess efficacy of antiretroviral therapies over time. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction. hbbd``b`s]@)Hpn ' $ bc@QH10009` 5 October 2017 (ICD-10) authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically Please do not use this feature to contact CMS. Nucleic acid quantification techniques are representative of rapidly emerging and evolving new technologies. incorporated into a contract. National Coverage Determination (NCD) NCDs are national policy granting, limiting or excluding Medicare coverage for a specific medical item or service. Reproduced with permission. Measurement of plasma HIV RNA levels should be performed at the time of establishment of an HIV infection diagnosis. Warning: you are accessing an information system that may be a U.S. Government information system. g|_'X\!4sSW4cH8HiLsd#G"nqO4? 1476 0 obj <>/Encrypt 1454 0 R/Filter/FlateDecode/ID[<3C25BBF2E2721941BD4AC7726C91DC5B><1790F444726A6247B813740B82426AED>]/Index[1453 36]/Info 1452 0 R/Length 110/Prev 370056/Root 1455 0 R/Size 1489/Type/XRef/W[1 3 1]>>stream View coverage of Sacral Nerve Stimulation for Urinary and Fecal Incontinence as defined by the CMS National Coverage Determination (NCD) 230.18. View Coverage and Billing requirements for Billing and Coding: Implantable Automatic Defibrillators coverage. endstream endobj 2099 0 obj <. 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Applications are available at the American Dental Association web site, http://www.ADA.org. 100-03, NCD Manual as a result of an NCD removal process through rulemaking in the Calendar Year 2021 Medicare Physician Fee Schedule (85 FR 84472, December 28, 2020). 0 Introduction to NCDs and LCDs: Learn What They Are and How to Find Them. 3 0 obj %PDF-1.5 % Assays vary both in methods used to detect viral RNA as well as in ability to detect viral levels at lower limits. Instructions for enabling "JavaScript" can be found here. NGS Medicare Virtual Conference Fall 2021 . CMS issued transmittal to communicate the revision of 240.2 of the National Coverage Determination (NCD) Manual, Publication (Pub.) 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To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom It will contain information about Medicare National Coverage Determinations (NCDs). x]s3x`[nw4m4)"[} Af# Cr}/]l~,Uy~*A#/ca {jW3 _1/Pn~5WTWF@fXxGHxLP(yIL KBN_E_F"Y83UUOTyo}{_XT]w9Ig~[@BoDg;Q y"sY Qk=DTS=_}+h]TxX=h>b#PTq)#P Rx DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated . Last Reviewed: 1/9/2023 October 2016 (ICD-10) CPT codes, descriptions and other data only are copyright 2002-2020 American Medical Association (AMA). October 2018 required field. July 2019 (PDF) (ICD-10) The Centers for Medicare & Medicaid Services finalized revisions to two separate, but medically related . %%EOF "JavaScript" disabled. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. '[e BOM9E-sazot Lx+F3x4#{f@_.t[9VM[Kv_h\Je#M8$%V CMS has removed six National Coverage Determinations (NCDs) from the Medicare Publication (Pub.) if(pathArray[4]){document.getElementById("usprov").href="/web/"+pathArray[4]+"/help/us-government-rights";} CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. %%EOF or 4 0 obj View coverage, coding and billing information for Outpatient Cardiac Rehabilitation defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria. The Centers for Medicare & Medicaid Services finalized revisions to Effective and Implementation dates NA. Section 240.2.2 of the National Coverage Determination (NCD) Manual (Pub. HIV quantification is often performed together with CD4+ T cell counts which provide information on extent of HIV induced immune system damage already incurred. NCDs are made through an evidence-based process, with opportunities for public participation. Viral quantification may be appropriate for prognostic use including baseline determination, periodic monitoring, and monitoring of response to therapy. January 2019 Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) *January 2021 Changes ICD-10-CM Version - Red Fu Associates, Ltd. January 2021 5 Non-covered ICD-10-CM Codes for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. This license will terminate upon notice to you if you violate the terms of this license. NCDs are made through an evidence-based process, with opportunities for public participation. 78429, 78430, 78431, 78432, 78433, 78434, 78459, 78491, 78492, 78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816, A4641, A9515, A9526, A9552, A9555, A9580, A9586, A9587, A9588, A9591, A9592, A9593, A9594, A9597, A9598, G0235, Q9982, Q9983, Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence. a^qvW)00Ex[=bQ?]Nq%L;Bz! End Users do not act for or on behalf of the CMS. You can decide how often to receive updates. var pathArray = url.split( '/' ); If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. ,RGA. @ & %PDF-1.5 To obtain comprehensive knowledge about the UB-04 codes, the Official UB-04 Data Specification Manual is available for purchase on the American Hospital Association Online Store. Before sharing sensitive information, make sure youre on a federal government site. 2098 0 obj <> endobj We're pleased to provide Medicare Coverage and Coding Reference Guides to help you more easily determine test coverage and find ICD-10 diagnosis codes to submit with your test order. 1 CBPe 3 Because differences in absolute HIV copy number are known to occur using different assays, plasma HIV RNA levels should be measured by the same analytical method. endstream endobj startxref 1488 0 obj <>stream Billing and Coding: Outpatient Cardiac Rehabilitation. NCDs are developed and published by CMS and apply to all states. There are times in which the various content contributor primary resources are not synchronized or updated on the same time interval. LCDs cannot contradict NCDs, but exist to clarify an NCD or address common coverage issues. 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April 2017 January 2017 (ICD-10) CDT is a trademark of the ADA. Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) NCD 190.31 January 2021 Changes ICD-10-CM Version - Red Fu Associates, Ltd. January 2021 1 190.31 - Prostate Specific Antigen Other Names/Abbreviations Total PSA Description 331 0 obj <>/Encrypt 311 0 R/Filter/FlateDecode/ID[<58D03DAB1834B8F5690247B103881366>]/Index[310 45]/Info 309 0 R/Length 108/Prev 130122/Root 312 0 R/Size 355/Type/XRef/W[1 3 1]>>stream 07/2002 - Implemented NCD. The instructions in the NCD replaces the current instructions in Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) NCD 190.18 January 2021 Changes ICD-10-CM Version - Red Fu Associates, Ltd. January 2021 3 Limitations 1. % Download the Guidance Document. 1 0 obj The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. endobj . 43644, 43645, 43770, 43845, 43846, 43847, 43775, Billing and Coding: Implantable Automatic Defibrillators. Resource: The CMS Medicare National Coverage Determinations Manual (Pub. Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: June 29, 2017. If an NCD does not specifically exclude/limit an indication or circumstance, or if the item or service is not mentioned at all in an NCD or in a Medicare manual, an item or service may be covered at the discretion of the MAC based on a Local Coverage Determination (LCD). Any questions pertaining to the license or use of the CDT should be addressed to the ADA. Click on the blue download arrow on the right side of page when LCD or Article appears. 2023 Noridian Healthcare Solutions, LLC Terms & Privacy. January 2018 (ICD-10) If endstream endobj startxref The NCD will be published in the Medicare National Coverage Determinations Manual. All Rights Reserved. endstream endobj startxref Secure .gov websites use HTTPSA In rare instances, if there is contradicting information in the NCD and LCD, the NCD overrides the LCD. :^U?Ymu*%;? If appropriate, the Agency must also change billing and claims processing systems and issue related instructions to allow for payment. 64561, 64581, 64585, 64590, 64595, A4290, C1767, C1778, C1820, C1883, C1897, L8680, Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing. April 2021 (PDF) (ICD-10) Download the Guidance Document Final Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: April 06, 2004 The scope of this license is determined by the AMA, the copyright holder. %PDF-1.5 If your session expires, you will lose all items in your basket and any active searches. Effective date 11/25/02. 33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, C7537, C7538, C7539, C7540, G0448, Billing and Coding: Intravenous Immune Globulin (IVIg) - NCD 250.3. By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE ("NUBC"), Point and Click American Hospital Association Copyright Notice, Copyright 2021, the American Hospital Association, Chicago, Illinois. =^|}rD"BrZp-spb@0\`d <> means youve safely connected to the .gov website. Please click here to see all U.S. Government Rights Provisions. ;.Cc(JWuWp,Wov}t]L 8q;\VAY!/5,QAn!;l^>tN\X;&V2YQv6(&Ao)6Haw October 2021 (PDF) (ICD-10) CMS PUB. NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device. -m#h8ry7_ &y+%~)cM\wW[=7; 1v)E$kkN`\::ULd$ro~y'Y%Jt2&i-`Q. Medicare coverage is limited to items and services that are considered "reasonable and necessary" for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). ?A|)vp1ICo+?Cl|H,H|> qq) XpRdgA]HykXew]~\y/R $\X _GDX`+rg~XvG+9/<9&(]}.Y`Arp!Xw YCD_?o- @' 9(C)fiQrH`?OD4a(tU:DGA9& KdJ3:hu$< EN2Syw9OD~y~jm )n62WlH"Asi=0N You can use the Contents side panel to help navigate the various sections. UsXAh/p=ACF1B!e y@2]C4$x,91*9 4_?SSyCGt>DI3?$A~ADy7n4ex;%{qYFB6T+8SnTh+bi')x,W*_? CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. 7500 Security Boulevard, Baltimore, MD 21244. July 2020 (PDF) (ICD-10) October 2015 (ICD-10, ICD-9) 0 :{+ $= !~kse38>kxt$ 2 0 obj There are multiple ways to create a PDF of a document that you are currently viewing. Federal government websites often end in .gov or .mil. 'AB@U79]O%"q2t(TUE]i;\mcLb":>#m :@ PYcncpSqlT phBhCU[2@ CdAv[\JNdiHHNN7 su %%EOF National Coverage Determinations (NCDs) are national policy granting, limiting or excluding Medicare coverage for a specific medical item or service. Unauthorized or illegal use of the computer system is prohibited and subject to criminal and civil penalties. Share sensitive information only on official, secure websites. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. 5689 0 obj <>/Filter/FlateDecode/ID[<404F802F6D2B094FB36B21BC9F638550>]/Index[5671 27]/Info 5670 0 R/Length 93/Prev 893369/Root 5672 0 R/Size 5698/Type/XRef/W[1 3 1]>>stream You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. FOURTH EDITION. ]J$-a$r`Cq K_`v1A G$h q$N2>(F x 'g A#o jj;mk5hz^=(?ljfqP@+@{,(B. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. C1^Q Ni=`*i);j1 %Uf%,|jNh#-O6^\mIb %914wQfiKzP&B]su!2sbU-j s#cLpNHpz;k}@&f_koHTO.sJ7i\`tg[f h}dlSR:=T0 d Z]JXc&1p)>'=AB- [2L^@ck)6:-Gkb%E6 HX`,_.K L7nAa OVe@*5KMn(Cl P-] P6xUZ5d*RjP.aZP,K&Z$,Da:fqp3 i_Djv"I-~ `*Xl)NReVg"m ^0 This includes items such as CPT codes, CDT codes, ICD-10 and other UB-04 codes. January 2020 (PDF) (ICD-10) G8- pf. The AMA is a third-party beneficiary to this license. HIV quantification is achieved through the use of a number of different assays which measure the amount of circulating viral RNA. 4. Users must adhere to CMS Information Security Policies, Standards, and Procedures. An official website of the United States government. hbbd```b`` It will contain information about Medicare National Coverage Determinations (NCDs). excluded from coverage under Title XVIII of the Social Security Act (SSA) 1862(a)(10) of the Act.) recipient email address(es) you enter. Medicare National Coverage Determinations (NCD) Manual. View coverage and billing requirements for sterilization services to prevent reproduction. Toll Free Call Center: 1-877-696-6775. NCDs can be found in the Medicare National Coverage Determinations Manual (Pub. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction. No fee schedules, basic unit, relative values or related listings are included in CDT. U.S. Department of Health & Human Services 55250, 58600, 58605, 58611, 58615, 58670, 58671. ;;=.vS[H ep@1flP j!i,@v4~b7M?;ipv\LFQCeb{/AsQ.*0 q8. CPT is a trademark of the AMA. 0 <> the Coverage Issues Manual (CIM). These situations include: Persistence of borderline or equivocal serologic reactivity in an at-risk individual. "H[`5d\@$k5_&xu9HL0 V"U?z blg201208`; ?u hT]lUCsiweb2;KC&d6 nX"&5B"C@! An official website of the United States government. A plasma HIV RNA baseline level may be medically necessary in any patient with confirmed HIV infection. January 2020 310 0 obj <> endobj AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. 0 Prior to implementation of an NCD, CMS must first issue a Manual Transmittal, CMS ruling, or Federal Register Notice giving specific directions to claims-processing contractors. The responsibility for the content of this file/product is with Noridian Healthcare Solutions or the CMS and no endorsement by the AMA is intended or implied. endstream endobj 311 0 obj <>>>/Filter/Standard/Length 128/O(%A}*UucD )/P -1340/R 4/StmF/StdCF/StrF/StdCF/U( y\\d6 )/V 4>> endobj 312 0 obj <>>> endobj 313 0 obj <> endobj 314 0 obj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 315 0 obj <>stream 2 0 obj endobj 7500 Security Boulevard, Baltimore, MD 21244, Medicare National Coverage Determinations (NCD) Manual, An official website of the United States government, Chapter 1 - Coverage Determinations, Part 2 Sections 90 - 160.26 (PDF), Chapter 1 - Coverage Determinations, Part 1 Sections 10 - 80.12 (PDF), Chapter 1 - Coverage Determinations, Part 3 Sections 170 - 190.34 (PDF), Chapter 1 - Coverage Determinations, Part 4 Sections 200 - 310.1 (PDF), Crosswalk from NCD Manual to Coverage Issues Manual (CIM) (PDF). An NCD sets forth the extent to which Medicare will cover specific services, procedures, or technologies on a national basis. 2119e*4Boh\sJ#);1Y^c+G"+d"f#pE8hE}N8&)G3vR"uSmcD^NT (!vgrgb@W;;VP&5wP"HL[k.>$:H;@. 5697 0 obj <>stream The use of the information system establishes user's consent to any and all monitoring and recording of their activities. X8Y2/1X85nz]{XD#(7KFlLqY var url = document.URL; October 2014 (ICD-10, ICD-9), January 2023 The Department may not cite, use, or rely on any guidance that is not posted January 2017 January 2022 (PDF) (ICD-10) ) 9=XLe 100-03) (PDF), Chapter 1, Part 1, 20.4 for Implantable Automatic Defibrillators and 20.8 for Cardiac Pacemakers. 2124 0 obj <>stream "JavaScript" disabled. The page could not be loaded. April 2018 u1OU~O kVy[ER;DqC|3a5#de` >~?FHWz7 WF0CZFO?f"n:1w&bzF. 2294_10/5/2021. The ADA is a third-party beneficiary to this Agreement. However, all employ some type of nucleic acid amplification technique to enhance sensitivity, and results are expressed as the HIV copy number. The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. After examining the available medical evidence, the Centers for Medicare & Medicaid determines that no national coverage determination (NCD) is appropriate at this time. Limitations. 2116 0 obj <>/Filter/FlateDecode/ID[<04643EEBA74F8D40A1AE468A86A9BC46>]/Index[2098 27]/Info 2097 0 R/Length 92/Prev 410965/Root 2099 0 R/Size 2125/Type/XRef/W[1 3 1]>>stream `!DVA9K+$\=>?BW9)I::_ $^D?i)Q>h:k?%6t)rM@~C*N7p"ph*{ZMuu l W&[%Ty{+/khxu1AJo]$ydwPF78jzJi6 TW g\\\bu`um*9xpt(s3'UA3P4EjX[AhmQ glQg9 As such, users are advised to remain current on FDA-approval status. <> In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. 7384 0 obj <>stream DEPARTMENT: Regulatory Compliance Support POLICY DESCRIPTION: Medicare National and Local Coverage Determinations for Physician Professional Services and Non-Hospital Entities PAGE: 1 of 6 REPLACES POLICY: 10/1/11, 10/1/15, 2/1/17 EFFECTIVE DATE: December 1, 2021 REFERENCE NUMBER: REGS.OSG.007 APPROVED BY: Ethics and Compliance Policy Committee . Final. View NCD 250.3 coverage guidelines for intravenous immune globulin. Other manuals in this system in which coverage-related instructions may be found are: Pub 100-02 (Benefit Policy); Pub 100-04 (Claims Processing); Pub 100-05 (Medicare Secondary Payer); and January 2016 (ICD-10) Another option is to use the Download button at the top right of the document view pages (for certain document types). Issued by: Centers for Medicare & Medicaid Services (CMS). Medicare Benefit Policy Manual, Chapter 15, 50.4.5 - Off-Label Use of Drugs and Biologicals in an Anti -Cancer . ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. Official websites use .govA View coverage, coding and billing information for Positron Emission Tomography Scans Coverage defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria. In clinical situations where the risk of HIV infection is significant and initiation of therapy is anticipated, a baseline HIV quantification may be performed. THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Manual Update. Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. July 2018 (PDF) (ICD-10) Medical Service Agreement (MA MSA) - The "Agreement" between HMO and IPA to facilitate the provision of prepaid health care for members of the HMO. The instructions in the NCD replaces the current instructions in the Coverage Issues Manual (CIM). endstream endobj startxref Your MCD session is currently set to expire in 5 minutes due to inactivity. Use as a diagnostic test method is not indicated. Also see the Medicare Claims Processing Manual, Chapter 120, Clinical Laboratory Services Based on Negotiated Rulemaking. 3 0 obj If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. 7308 0 obj <> endobj Viral quantification may be appropriate for prognostic use including baseline determination, periodic monitoring, and monitoring of response to therapy. Medicare National Coverage Determination (NCD) Manual Sets policy for determining medical necessity for specific services You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. F>I,bgGVJcQ$>cJ-Q4uPq?t/U90$b(KCM`T:^okzoku!k,k[+V. Instructions for enabling "JavaScript" can be found here. Billing and Coding: Positron Emission Tomography Scans Coverage. View bariatric surgery procedures defined by NCD as reasonable and necessary under specified conditions for the treatment of complications of morbid obesity. If you would like to extend your session, you may select the Continue Button. Making copies or utilizing the content of the UB-04 Manual or UB-04 Data File, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual / Data File or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. January 2019 (PDF) (ICD-10) 7322 0 obj <>/Filter/FlateDecode/ID[<26A19838D1D68647BDD29C1930E75835>]/Index[7308 77]/Info 7307 0 R/Length 76/Prev 817389/Root 7309 0 R/Size 7385/Type/XRef/W[1 2 1]>>stream endobj 100-03), Chapter 1, Part 4, and to inform the . 0 {vx#CBP3$ayCf/sOZo *j April 2018 (PDF) (ICD-10) 100-03, Chapter 1, Part 4, and to inform the Medicare Administrative Contractors (MACs) of the changes associated with this NCD, effective Sept. 27, 2021, as amended July 8, 2022. NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device. Section 240.2.2 of the National Coverage Determination (NCD) Manual (Pub. An asterisk (*) indicates a April 2020 %PDF-1.6 % ][/lE7gj[VOG,^5> 11/10/2021. Last Updated Tue, 14 Feb 2023 14:51:54 +0000. 4 0 obj At any time, and for any lawful Government purpose, the government may monitor, record, and audit your system usage and/or intercept, search and seize any communication or data transiting or stored on this system. /V[DNlEeekCef41Vo8K!rB_*?ET'/PV~qvl'|D7\ 8h(1zFb?SkQ!OBC+9T+gr~ 100-03) LCDs are published by each Medicare Administrative Contractor (MAC). of every MCD page. Medical Review Department, medical policies, Advance Determination of Medicare Coverage (ADMC) process, and Prior Authorization. endstream endobj startxref else{document.getElementById("usprov").href="/web/"+"jeb"+"/help/us-government-rights";}, Advance Beneficiary Notice of Noncoverage (ABN), Cardiac and Pulmonary Rehabilitation Programs, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), Acute Inpatient Prospective Payment System (IPPS) Hospital, Comprehensive Outpatient Rehabilitation Facility (CORF), Fee-for-Time Compensation Arrangements and Reciprocal Billing, Outpatient Prospective Payment System (OPPS), Provider Appeal Requests - PRRB or Contractor Hearings, Provider Statistical and Reimbursement (PS&R) System, Documentation Requests: How, Who and When to Send, Medical Documentation Signature Requirements, Supplemental Medical Review Contractor (SMRC), Unified Program Integrity Contractor (UPIC), Provider Outreach and Education Advisory Group (POE AG), PECOS and the Identity and Access Management System, Provider Enrollment Reconsiderations, CAPs, and Rebuttals, CMS Medicare Coverage Determination Process, click here to see all U.S. Government Rights Provisions, American Hospital Association Online Store, Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees, View coverage guidelines for Arthroscopic Lavage and Debridement for Osteoarthritic Knees, Billing and Coding: Bariatric Surgery Coverage.