What are the elements of a health care database?
Database. The term database embraces many different concepts: from paper records maintained by a single practitioner to the vast computerized collections of insurance claims for Medicare beneficiaries; from files of computerized patient encounter forms maintained by health plans to discharge abstract databases of all hospitals in a given state; from cancer and trauma …
What is included in the Medicare survey?
Medicare eligibility responses based on the tool you use. You can use all online tools and services to get eligibility information. Enter your patient’s: Medicare Beneficiary Identifier (MBI) First and last name Date of birth (MM/DD/YYYY) When the information matches a Medicare record, we’ll return information like:
What is the Medicare coverage database (MCD)?
Oct 01, 2015 · Article converted to Billing and Coding, no change in coverage made. 10/08/2018. R1. This Jurisdiction F Part B (JFB) article has been revised to add the Jurisdiction F Part A (JFA) contract. Both JFA and JFB contract numbers will have the same final MCD article number A52770. No change in coverage was made.
What is the importance of computer-based patient records?
Sep 02, 2021 · Questionnaires, when administered to all patients and results given to clinicians irrespective of baseline score, had no impact on recognition (RR 1.03, 95% CI 0.85 - 1.24). Screening or case-finding increased the use of any intervention by a …
What are some examples of Medicare coverage documents?
Examples include guidance documents, compendia, and solicitations of public comments. Close.
What percentage of Medicare beneficiaries are excluded from coverage?
For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug.
What is MEDCAC in medical?
The MEDCAC reviews and evaluates medical literature, reviews technology assessments, public testimony and examines data and information on the benefits, harms, and appropriateness of medical items and services that are covered under Medicare or that may be eligible for coverage under Medicare.
What is a local coverage determination?
A Local Coverage Determination (LCD) is a decision made by a Medicare Administrative Contractor (MAC) on whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within the specific jurisdiction that the MAC oversees. MACs are Medicare contractors that develop LCDs and process Medicare claims.
What is local coverage article?
Local coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). Articles often contain coding or other guidelines that complement a Local Coverage Determination (LCD). MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims.
Why are CPT codes not included in CPT codes?
They are used to identify various items and services that are not included in the CPT code set because they are medical items or services that are regularly billed by suppliers other than physicians. For example, ambulance services, hearing and vision services, drugs, and durable medical equipment.
What is a LCD in Medicare?
LCDs are specific to an item or service (procedure) and they define the specific diagnosis (illness or injury) for which the item or service is covered. LCDs outline how the contractor will review claims to ensure that the services provided meet Medicare coverage requirements.
What is a database?
As commonly used and meant in this report, a database (or, sometimes, data bank, data set, or data file) is ''a large collection of data in a computer, organized so that it can be expanded, updated, and retrieved rapidly for various uses" (Webster's New World Dictionary, 2nd ed.).
What is the benefit of information that encourages insurers or others to contract only with certain providers in a community?
For example, information that encourages insurers or others to contract only with certain providers in a community, on grounds of either quality or cost, is doubtless of benefit to those insurers and providers, and it does give insurers the opportunity to direct patients toward high-quality providers.
How can HDOs improve quality of care?
HDOs can also contribute to improvements in quality of care by making information available to institutions and groups of practitioners for their use in quality assurance and quality improvement (QA/QI) programs and for regional health planning.
What is secondary database?
Secondary databases facilitate reuse of data that have been gathered for another purpose (e.g., patient care, billing, or research) but that, in new applications, may generate new knowledge.
How many states have discharge abstracts?
Hospital discharge abstracts are common sources of publicly held data: 36 states have mandates for the collection, analysis, and dissemination of hospital-level information for prudent purchasing, decision making, education of the public, and rate regulation.
Which state has passed legislation that mandates development of a statewide data system?
For example, Washington state has passed legislation that mandates development of a statewide data system by a health services commission that will identify a set of health care data elements to be submitted by all providers (e.g., hospitals and physicians) (Engrossed Second Substitute Senate Bill 5304, 1993).
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Article Guidance
We are providing clarification of coverage and documentation requirements for pulmonary rehabilitation services based on Noridian medical review findings.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
Decision Summary
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that screening for depression in adults, which is recommended with a grade of B by the U.S.
Decision Memo
The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that screening for depression in adults, which is recommended with a grade of B by the U.S.