Question

2. Explain, in your own words, what details you need to determine an accurate HCPCS Level II code

3. Create a scenario illustrating a physician providing this procedure. Include the diagnosis for which this procedure would be medically necessary.

4. Report the accurate HCPCS Level II code or codes. Include any necessary modifiers.

Answer 1

2. THE CENTERS FOR MEDICARE & MEDICAID SERVICES IS UPDATING ITS HEALTHCARE COMMON PROCEDURAL CODING SYSTEM LEVEL-II CODING PROCEDURES TO ENABLE SHORTER AND MORE FREQUENT HCPCS CODE APPLICATION CYCLES. BEGINNING IN JANUARY 2020 CMC WILL IMPLEMENTS QUARTERLY HCPCS CODE APPLICATION OPPORTUNITIES FOR DRUG AND BIOLOGICAL PRODUCT AND BI-ANNUL APPLICATION OPPORTUNITIES FOR DURABLE MEDICAL EQUIPMENT, ORTHOTICS, PROSTHETICS AND SUPPLIES AND OTHER NON DRUG, NON BIOLOGICAL PRODUCT

3. A WIDE VARIETY OF TECHNOLOGIES AND TOOLS ARE INVOLVED IN THE DIAGNOSTIC PROCESS BUT PRIMARY FOCUS OF THE CHAPTER IS ON HEALTH INFORMATION TECHNOLOGIES TOOLS HEALTH IT COVER A BOARD RANG OF TECHNOLOGIES USED IN HEALTH CARE INCLUDING ELECTRONIC HEALTH RECORDS. ( EHRS) CLINICAL DECISION SUPPORT, PATIENT ENGAGEMENT TOOLS, COMPUTERIZED PROVIDER ORDER ENTRY, LABORATORY AMD , MEDICAL IMAGING INFORMATION SYSTEM, HEALTH INFORMATION EXCHANGE, AND MEDICAL DEVICES, HEALTH IT PLAYS KEY ROLES IN VARIOUS ASPECTS OF THE DIAGNOSIS PROCESS:CAPTURING INFORMATION ABOUT A PATIENT THAT INFORM THE DIAGNOSIS PROCESS INCLUDING THE CLINICAL HISTORY AND INTERVIEW, PHYSICAL EXAM AND DIAGNOSIS TESTING RESULTS; SHAPING A CLINICIANS WORKFLOW AND DECISION MAKING IN THE DIAGNOSIS PROCESS AND FACILITATING INFORMATION EXCHANGE.

THE COMMITTEE CONCLUDED THAT HEALTH IT HAS POTENTIAL TO IN IMPACT THE DIAGNOSTIC PROCESS IS BOTH POSITIVE AND NEGATIVE WAYS. WHEN HEALTH IT TOOL SUPPORT DIAGNOSTIC TEAM MEMBER AND TASK IN THE DIAGNOSTIC PROCESS AND REFLECT HUMAN CENTERED DESIGN PRINCIPLES, HEALTH IT HAS THE POTENTIAL TO IMPROVE DIAGNOSIS AND REDUCE DIAGNOSTIC ERROR. DESPITE THIS POTENTIAL, HOWEVER , THERE HAVE BEEN FEW DEMONSTRATION THAT HEALTH IT ACTUALLY IMPROVES DIAGNOSIS IN CLINICAL PRACTICE INDEED, MANY EXPERTS ARE CONCERNED THAT CURRENT HEALTH IT TOOLS ARE NOT EFFECTIVELY FACILITATING THE DIAGNOSIS PROCESS AND MAY BE CONTRIBUTING TO DIAGNOSIS ERROR THIS CHAPTER DISCUSSES THE DESIGN OF HEALTH IT FOR THE DIAGNOSTIC PROCESS, THE INTEROPERABILITY OF PATIENT HEALTH INFORMATION, PATIENT SAFETY ISSUES RELATED TO HEALTH IT AND POTENTIAL FOR HEALTH IT TO AID IN THE MEASUREMENT OF DIAGNOSIS ERROR

THE MEDICAL NECESSITY CAN HELP AN OVERARCHING TERM TO DESCRIBE SOMETHING THAT IS ABSOLUTELY NEEDED TO HELP SOMEONE SURVIVE OR GET BETTER. IN TERM OF MEDICARE AND HEALTHCARE IN GENERAL MEDICALLY NECESSARY IS AN IMPORTANT TERM WHEN DETERMINING WHAT IS COVERED, OR NOT COVERED, BY YOUR PLAN.

GIVE THAT THIS CONCEPT IS SO IMPORTANT THAT YOUR MEDICARE COVERAGE RELIES ON IT WHAT DOES OT MEANS? WHAT IS MEDICALLY NECESSARY AND WHAT ISN'T WHEN HAPPEN WHEN YOU NEED SOMETHING THAT DOESN'T FIT THIS TERM? WE'VE COVERED ALL OF THESE CONCERNS, AND WE'LL START WITH WHAT ''MEDICALLY NECESSARY'' ACCORDING TO THE MEDICARE GLOSSARY MEDICALLY NECESSARY REFER TO: HEALTH CARE SERVICE OR SUPPLIES NEEDED TO DIAGNOSIS OR TREAT AN ILLNESS, INJURY, CONDITION, DISEASE, OR ITS SYMPTOMS AND THAT MEET ACCEPTED STANDARDS OF MEDICINE.

ANYTHING DEEMED '' MEDICALLY NECESSARY IT VITAL TO THE MEDICARE PROCESS AND COVERAGE BECAUSE MEDICARE ONLY HELPS PAY FOR WHAT IS ABSOLUTELY NEEDED TO HELP TREAT AN INJURY, ILLNESS, OR OTHER MEDICAL CONDITION.