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Home > Archive > June 2003
Coding & Billing
Avoiding Denials of Questionable Covered Services
Lolita M. Jones, RHIA, CCS

Lolita M. Jones, RHIA, CCS You can't automatically assume that a procedure is eligible for reimbursement just because it's on the Centers for Medicare and Medicaid Services' (CMS) list of covered ASC procedures. CMS designates some procedures as Questionable Covered Services (QCS), which means that they are only covered when medically necessary. Examples include certain types of blepharoplasty, rhytidectomy, lipectomy, mammaplasty and abortion. Here are three ways to make sure you don't end up with unpleasant surprises when the time comes to collect reimbursement for these cases.

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