Q2: Coding and Documentation Flashcards
1
Q
Medicare
A
Federally Funded/Operated
Typically for geriatric and disabled patients
2
Q
Medicaid
A
State and Federal Programs
Typically for poor patients
3
Q
Riembursment Process
A
- Facility must me DMEPOS standards
- Must obtain/retain Medicare billing privileges
- Ensure documentation is included and completed correctly
4
Q
Verbal Rx Orders must contain…
A
- Item description
- Beneficiary’s name
- Physician’s name
- Date (start of order)
5
Q
Written Rx Orders must contain…
A
- Start date
- All features that will need to be billed seperately
- Treating physician must review and personally sign/date order
6
Q
Who can sign Rx’s?
A
- Physicians
- Podiatrists
- NPs
- PAs
7
Q
Delivery Slips methods
Proof of Delivery
A
- Provider delivers directly to beneficiary/designee
- Provider uses a shipping service to deliver
- Delivery of items to a nursing facility on behalf of a beneficiary
8
Q
Direct Delivery needs to include…
Proof of Delivery
A
- Beneficiary’s name
- Delivery address
- Description of item
- Quantity
- Date delivered (date recieved)
- Beneficiary signature
9
Q
LCD
A
“Local Coverage Determination”
-developed by DME MACs
10
Q
What are there LCDs for?
A
- LL Px
- Ext. Breast Px
- Spinal Ox
- Knee Ox
- AFO/KAFOs
- Orthopedic Footwear
- Theurapeutic shoes for diabetics
11
Q
AFO/KAFO inclusion criteria
LCD Policy
A
- Rigid/Semirigid
- Used to support weak or deformed body part OR to restrict motion in a diseased or injured body part
- Meet the definition of a brace
12
Q
Orthopedic Footwear inclusion criteria
LCD Policy
A
- Must be attached to a brace
- Non-coverage for shoes/inserts/mods
13
Q
Therapeutic Shoes inclusion criteria
LCD Policy
A
- Covered with extensive documentation
- patient has diabetes mellitus
- patient has amp, ulcer, calluses, etc., etc., etc.
- Physcian signing must be managing diabetes and be an MD or DO, and confirm diagnosis, and, and,…….
