Statistics paint a stark reality of chronic obstructive pulmonary disease (COPD), which is now the fourth leading cause of death in the United States, claiming more than 130,000 lives each year. Of the top 10 leading causes of death in the United States, COPD is the only one with increasing incidence, and it is on track to become the third leading cause of death by the year 2015.
With the recently published and long-awaited CPAP local coverage determinations (LCDs), the intake, billing and reimbursement departments will require some new checks and balances if providers have any expectation of payment. That’s because the LCDs, which apply to dates of service on or after Sept. 1*, include newly imposed hoops for the provider to jump through in order to file a clean claim. The following hoops, which will need to be cleared first by intake staff or customer service, include the collection of documents that must be in a provider’s files. These documents must reflect that the patient had a face-to-face evaluation prior to the sleep test.