HI 215 PGU The Medicare Medical Necessity Offer to A Certain Victim Analysis

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Medicare Medical Necessity Local Coverage Determinations (LCDs) orlocal coverage determinations specify under what clinical circumstances aservice is covered.

• Explain medical necessity.
• From the Medicare Coverage Database, access the Local Coverage Determinations (LCDs) Alphabetical Index.Locate and present a procedure/service to determine whether Medicarecovers that procedure or service, by scrolling down and clicking on theblue ID to select the procedure (L32553) (the first time might include aLicense Agreement, go to bottom right and agree, otherwise, when youclick the code the information on it will open
• Evaluate the details of coverage for your selected code, includingthe ICD-10 codes which support medical necessity. In your response,include identified limitations and stipulations surrounding the service.
• Defend included medical necessity codes with examples of possible application.

Reference:

Centers for Medicare and Medicaid Services. (n.d.). Local coverage determinations (LCDs) alphabetical index.https://www.cms.gov/medicare-coverage-database/ind…