Medical Necessity/ CCI Tools

In the ever-changing world of medical billing, staying on top of policies issued by CMS and Medicare contractors can be a real challenge, requiring valuable time and resources. However, the cost of not being in compliance is greater. Procedure code combinations that aren’t allowed because of Correct Coding Initiative (CCI) provisions result in reduced reimbursements or denials. Procedures that are classified as medically unnecessary according to NCD/LCD are refused payment unless the patient signs an Advance Beneficiary Notice (ABN).

How do you ensure that you will be fairly reimbursed for the services you provide? By subscribing to Compliance Tools or Medical Necessity Datafiles from Quadax.

Compliance Tools allow you to easily check medical necessity and correct coding rules from the ASP Portal. If your Information System already features medical necessity checking, keep up to date on all local and national policies by subscribing to the Medical Necessity Datafiles applicable for your region.

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