Ascendant Medical Laboratory

On August 25, 2008, the Centers for Medicare and Medicaid Services (CMS) released a guide to assists stakeholders with better understanding the processes used to determine coverage, coding and payment for new technologies under the Medicare program.

The “Innovator’s Guide to Navigating CMS” is a single resource document to streamline the coding and payment process.

The guide provides a general overview and sections on coverage, coding and payment.
- The coverage section discusses national coverage determinations (NCDs) and the NCD process, and local coverage determinations (LCDs).
- The coding section provides an overview of the ICD-9-CM and HCPCS coding systems and a chart comparing each code set.
- The payment section outlines each individual payment system, i.e., Inpatient Prospective Payment System (IPPS), Hospital Outpatient Prospective Payment System (HOPPS) and Physician Fee Schedule (PFS). There is a brief section on clinical laboratory services.

To read the “Innovators Guide to Navigating CMS,” visit http://www.cms.hhs.gov/CouncilonTechInnov/Downloads/InnovatorsGuide8_25_08.pdf.

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