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 LMRP
Data File List
LMRP Data files
Description
Validating medical necessity is the key to successful healthcare
procedure planning and reimbursement. When billing for Medicare
services, the Centers for Medicare & Medicaid Services (formally
HCFA) mandates that providers meet medical necessity guidelines
according to their contractor's Local Medical Review Policies (LMRP)
and conform to many other coding conventions.
Updated monthly, our comprehensive data files provide the tools
to meet Medicare compliance challenges. We bring together the technical
expertise and medical knowledge necessary to maintain the LMRP data
with unmatched quality, accuracy and affordability.
At the point of scheduling, registration, or ordering of services,
use this data to validate medical necessity and ensure ABNs are
generated when necessary, prior to services rendered.
At the point of claims submission, use this data to ensure that
claims are clear of errors prior to billing Medicare and private
payers. Reducing denied submissions can significantly improve reimbursement
and reduce the risk of audits.
Our LMRP data files provide:
HCPCS/CPT® to ICD crosswalks
Policy Titles, Effective Dates, Policy Numbers, Frequency
Limitations
URL pointers to each policy on the Carriers Internet
site
Electronic versions of the full Policy
Only valid ICD and CPT codes. ICD codes are provided
to their correct 4th or 5th digit specificity.
Files are available for all Carriers (Part B) and
Fiscal Intermediaries (Part A).
Call us for a demonstration
and pricing
Request
our White Paper "Medical Necessity - Data needs for the
Medical Industry"
CPT® is a Registered Trademark of the American
Medical Association.
Information & Orders: Call (520) 529.5515
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