Stream: Da Vinci PCT
Topic: CMS Guidance Issued
Stanley Nachimson (Apr 08 2022 at 13:28):
CMS has recently issued new GFE and NSA guidance. Diagnosis codes may not be required on certain GFEs -“A provider or facility is required to provide a diagnosis code only where one is required
for the calculation of the GFE. For example, in situations in which a provider or facility has not
determined a diagnosis, such as for initial screening visits or evaluation and management visits;
or if there is not a relevant diagnosis code for an item or service, such as for certain dental
screenings or procedures, providers and facilities are not required to include diagnosis codes on a
GFE. However, the provider or facility must include the expected charges and service codes for
the items and services to be furnished during that visit, even when no diagnosis code is available. “, and also the NPI of the provider must be the one for the provider furnishing the service, and not a “group” NPI. The guidance is available on the CMS NSA web site.
Last updated: Apr 12 2022 at 19:14 UTC
