Compliance Question of the Week – General

I can no longer find the FAQs that CMS once had on its homepage. Any idea where they went?

I am starting to hear more about a CMS program called TPE. What does this stand for, and what is its purpose?

If a procedure or service has been assigned a CPT® code, does that mean Medicare will cover it?

One of our physicians sent a patient to the outpatient department to have a PICC line inserted (36568 or 36569) and have the first round of therapeutic medications (96365, 96366, 96367, 96368) on the same day. Can you please tell us if the insertion of a PICC line and the administration of the antibiotic drug can be charged on the same day with a modifier of 59 or XU?

Can you explain Medicare’s policy regarding when an inpatient admission changes to outpatient?

If a record only states “lupus” what would this condition map/code to? I am an auditor at work, and I am in a debate on how to code lupus not otherwise specified (NOS). I say this condition codes to L93.0 but a colleague suggests I am incorrect and that lupus should code/map to M32.9? Do you have any guidance on this particular condition?

How should we bill Medicare for cochlear devices replaced without cost to the hospital or beneficiary?

Where can we find the evaluation and management documentation guidelines?

How do I request a change in the MUE value for a CPT® code?

What is the difference between medical necessity and medical decision-making?

Do CPT® codes for psychological and neuropsychological tests include tests performed by technicians and computers?

I’d like to find out more about the new Medicare diabetes-prevention program. Can you supply a source?