There are times when documentation is
incomplete or insufficient to support the
diagnoses found in the chart. The most
common way of communicating with the
physician for answers is by
If a participating provider's usual fee for a
service is $700.00 and Medicare's allowed
amount is $450.00, what amount is written
off by the physician?
All of the following items are "packaged"
under the Medicare ASC payments,
LCDs and NCDs are review policies that
describe the circumstances of coverage
for various types of medical treatment.
They advise physicians which services
Medicare considers reasonable and
necessary and may indicate the need for
an advance beneficiary notice. They are
developed by the Centers for Medicare
and Medicaid Services (CMS) and
Medicare Administrative Contractors. LCD
and NCD are acronyms that stand for
When health care providers are found
guilty under any of the civil false claims