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Introduction<br />
<strong>PRESTIGE</strong> ®<br />
Cervical Disc<br />
Reimbursement Guide<br />
Section 1: Introducing the <strong>PRESTIGE</strong>® Cervical Disc 2<br />
Section 2: Coverage 3<br />
Benefits 3<br />
Risks 3<br />
Medical Necessity 5<br />
Documentation Requirements 7<br />
Section 3: Physician Coding and Payment 9<br />
ICD-9-CM Diagnosis Codes 9<br />
Current Procedural Terminology Codes 9<br />
Illustration of Anterior Cervical Surgical Technique 10<br />
Sample CMS-1500 Claim Form 11<br />
Section 4: Hospital Inpatient Coding and Payment 13<br />
Payment Methodologies 13<br />
ICD-9-CM Diagnosis Codes 14<br />
ICD-9-CM Procedure Codes 14<br />
Diagnosis-Related Groups (DRGs) 15<br />
Bill Type Codes 15<br />
Revenue Center Codes 15<br />
Sample UB-04 Claim Form 16<br />
Section 5: Hospital Outpatient Coding and Payment 17<br />
HCPCS Codes and Ambulatory Payment Classification (APC) Assignment 17<br />
Bill Type Codes 17<br />
Revenue Center Codes 17<br />
Coverage in the Hospital Outpatient Setting 17<br />
Section 6: Handling Denials 19<br />
Sample Appeal Letter 20<br />
Section 7: Frequently Asked Questions 21<br />
Section 8: Coding and Reimbursement Assistance 23
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